Individual provider Active NPI

Carol M Marquis, O.D.

  • Optometrist
  • Zephyrhills, FL
National Provider Identifier
1780797399
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2776 Issued in FL
Practice address
6329 Gall Blvd
Zephyrhills, FL 33542-2515
Phone
(813) 788-7616
Fax
(813) 783-2856
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC2776 FL Primary

Addresses

Primary practice location

6329 Gall Blvd
Zephyrhills, FL 33542-2515

Mailing address

6329 Gall Blvd
Zephyrhills, FL 33542-2515
Phone (813) 788-7616

Other identifiers 1

IdentifierTypeStateIssuer
620485600MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmarquis@brandoneyeassociates.intellichartdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100127000811 FL Practitioner - Optometry 9638211790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stuart J Kaufman MD and Assoc PAGroup PAC ID 0143299495, 8 clinicians

Practice addresses (Care Compare)

6329 Gall Blvd
Zephyrhills, FL 33542-2515
Phone (813) 788-7616

Merit-based Incentive Payment System (MIPS)

Final score
90 of 100Reported as group
Quality
95.5
Improvement activities
40
Cost
72.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC2776FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Stuart J Kaufman MD & Assoc PA Optometrist CurrentSince Nov 3, 2020 Accepting new patients
Stuart J Kaufman MD & Assoc PA CurrentSince Nov 3, 2020 Accepting new patients
Kurt Theodore OD PA Optometrist Past Accepting new patients
Stuart J Kaufman MD & Assoc PA Optometrist Past Accepting new patients

Locations

1814 W County Road 48
Bushnell, FL 33513
Phone (352) 568-0600

4002 Sun City Center Blvd
Unit 103
Sun City Center, FL 33573
Phone (813) 634-9289

2145 Cypress Ridge Blvd
#201
Wesley Chapel, FL 33544
Phone (813) 973-1133

6329 Gall Blvd
Zephyrhills, FL 33542
Phone (813) 788-7616

Organizations & group practices 5

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1780797399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6329 GALL BLVD",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335422515",
            "telephone_number": "813-788-7616",
            "fax_number": "813-783-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6329 GALL BLVD",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335422515",
            "telephone_number": "813-788-7616",
            "fax_number": "813-783-2856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUIS",
        "first_name": "CAROL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620485600",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmarquis@brandoneyeassociates.intellichartdirect.net",
            "affiliation": "N",
            "address_1": "540 Medical Oaks Ave Ste 103",
            "city": "Brandon",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335115995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

Verify at the official NPI Registry.