Mark Paul Maher, OD – Optometrist in Morgan Hill, CA

Key facts

NPI: 1811049810
Entity type: Individual (NPI type 1)
Primary specialty: Optometrist 152W00000X
License: 79887 (CA)
Practice address: 419 Vineyard Town Center
Morgan Hill, CA 95037
Phone: (408) 779-2266
Fax: (408) 779-5051
NPI assigned: Jan 18, 2007
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

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.

Mark P Maher Optometric Corporation Clinic/Center · Morgan Hill, CA · NPI 1003305657

Medicare reassignment Care Compare group NPD CA

Medicare Care Compare profile

Specialty: Optometry
Education: University of California - School of Optometry, 1984
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Mark P Maher Optometric Corporation (2 clinicians)

Practice addresses (Care Compare)

419 Vineyard Town Ctr
Morgan Hill, CA 95037-5631
Phone (408) 779-2266

Medicare participation

Medicare fee-for-service enrollment: Enrolled in CA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20090609000333	CA	Practitioner - Optometry	6507916756	Reassigns benefits to 1 organization Receives reassigned benefits from 2 practitioners Practice locations: Morgan Hill, CA

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
79887	CA	MD	Pharmacist

Practice roles

Organization	Specialty	Status	New patients
Mark P Maher Optometric Corporation		Current since May 11, 2018	Accepting new patients

Locations

419 Vineyard Town Ctr
Morgan Hill, CA 95037
Phone (408) 779-2266

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Optometrist	152W00000X	79887	CA	Yes

Addresses

Primary practice location

419 Vineyard Town Center
Morgan Hill, CA 95037

Mailing address

419 Vineyard Town Center
Morgan Hill, CA 95037
Phone (408) 779-2266

Other identifiers

Identifier	Type	State	Issuer
BT609A	Other	CA	PTAN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 2, 2010.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1811049810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 VINEYARD TOWN CENTER",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "95037",
            "telephone_number": "408-779-2266",
            "fax_number": "408-779-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 VINEYARD TOWN CENTER",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "95037",
            "telephone_number": "408-779-2266",
            "fax_number": "408-779-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHER",
        "first_name": "MARK",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "79887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "BT609A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgan Hill, CA

All providers in Morgan Hill, CA · Optometrist in California

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.