Mark Jared Fast, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2986ATI Issued in OR

Practice address

3816 Center St NE
Salem, OR 97301-2905

Phone

(503) 588-5513

Fax

(503) 588-5470

NPI assigned

Dec 5, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eye Focus Northwest LLC

  • Optometrist
  • Salem, OR
  • NPI 1033401062
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1831173590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 CENTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012905",
            "telephone_number": "503-588-5513",
            "fax_number": "503-588-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 CENTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012905",
            "telephone_number": "503-588-5513",
            "fax_number": "503-588-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAST",
        "first_name": "MARK",
        "middle_name": "JARED",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2986ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Kimball Farris, PT
• David Farthing, M.D.
• Mohammad Aman Fasahat, M.D.
• Celeste Fasano, LMT
• Gavin Fast, PHARMD
• Lacey Faughender, LCSW
• Amanda Jeanette Faulkner
• Josiah D Faville, D.P.T.
• Sara Faville, LMT
• Kathryn Fawley, L.M.T.

• Optometrist in Salem, OR
• Providers in Salem, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (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.