Individual provider Active NPI

Marianna Samuels, O.D.

  • Optometrist
  • Encinitas, CA
National Provider Identifier
1760767461
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14196TLG Issued in CA
Practice address
477 N El Camino Real Ste C202
Encinitas, CA 92024-1332
Phone
(760) 631-3500
NPI assigned
Oct 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 14196TLG CA Primary

Addresses

Primary practice location

477 N El Camino Real Ste C202
Encinitas, CA 92024-1332

Mailing address

477 N El Camino Real Ste C202
Encinitas, CA 92024-1332
Phone (760) 631-3500

Other practice location 1

7305 Pacific Blvd Fl 3
Huntington Park, CA 90255-5736
Phone (323) 587-7000

Other names 1

  • Dr. Marianna Mkrtchyan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120509000385 CA Practitioner - Optometry 8527220524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North County Eye Physicians, IncGroup PAC ID 1355507567, 9 clinicians
North County Eye Center, Inc.Group PAC ID 0143274225, 11 clinicians

Practice addresses (Care Compare)

15706 Pomerado Rd
Suite 103
Poway, CA 92064-2032
Phone (858) 451-8600

225 E 2ND Ave
Suite 310
Escondido, CA 92025-4202
Phone (760) 738-9985

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14196CAMDMental Health Counselor
14196TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
North County Eye Physicians, Inc CurrentSince Aug 18, 2020 Accepting new patients
North County Eye Center, Inc. Optometrist CurrentSince Aug 18, 2020 Accepting new patients
Duane Decroupet OD a PC Optometrist Past Accepting new patients

Locations

225 E 2nd Ave
Ste 310
Escondido, CA 92025
Phone (760) 738-9985

251 E 4th Ave
Escondido, CA 92025
Phone (760) 738-9985

15706 Pomerado Rd
Ste 103
Poway, CA 92064
Phone (858) 451-8600

838 Nordahl Rd
Ste 220
San Marcos, CA 92069
Phone (760) 738-9985

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1760767461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL STE C202",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241332",
            "telephone_number": "760-631-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL STE C202",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241332",
            "telephone_number": "760-631-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7305 Pacific Blvd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Huntington Park",
            "state": "CA",
            "postal_code": "902555736",
            "country_code": "US",
            "telephone_number": "323-587-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "MARIANNA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14196TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIANNA",
            "last_name": "MKRTCHYAN",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.