Individual provider Active NPI

Mark Lurie, M.D.

  • Ophthalmology Physician
  • Castro Valley, CA
National Provider Identifier
1750315123
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
00G052104 Issued in CA
Practice address
20046 Lake Chabot Rd
Castro Valley, CA 94546-5304
Phone
(510) 881-8823
Fax
(510) 881-2134
NPI assigned
Jul 10, 2006
Last updated
Apr 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 00G052104 CA Primary

Addresses

Primary practice location

20046 Lake Chabot Rd
Castro Valley, CA 94546-5304

Mailing address

20046 Lake Chabot Rd
Castro Valley, CA 94546-5304
Phone (510) 881-8823

Other identifiers 1

IdentifierTypeStateIssuer
GR0046700MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00G052104CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Township Hospital District Past Accepting new patients
Eye Specialties Medical Group Inc. Ophthalmology PastSince Jun 22, 2021 Accepting new patients
Kenneth C. Low MD a Professional Corporation Ophthalmology PastSince Jul 1, 1993 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1750315123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20046 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465304",
            "telephone_number": "510-881-8823",
            "fax_number": "510-881-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20046 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465304",
            "telephone_number": "510-881-8823",
            "fax_number": "510-881-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LURIE",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "00G052104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0046700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.