Individual provider Active NPI

Joseph T. Marra, OD

  • Corneal and Contact Management Optometrist
  • Toledo, OH
National Provider Identifier
1831194869
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
4212 Issued in OH
Practice address
4240 Secor Road
Toledo, OH 43623-4238
Phone
(419) 475-6605
Fax
(419) 475-2017
NPI assigned
Jun 16, 2005
Last updated
Apr 27, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 4212 OH Primary
Pediatric Optometrist 152WP0200X 4212 OH

Addresses

Primary practice location

4240 Secor Road
Toledo, OH 43623-4238

Mailing address

4240 Secor Road
Toledo, OH 43623-4238
Phone (419) 475-6605

Other identifiers 1

IdentifierTypeStateIssuer
0504387MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090923000214 OH Practitioner - Optometry 5395891949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. Marra, Optometrist, LLCGroup PAC ID 5890014989, 2 clinicians

Practice addresses (Care Compare)

5834 Monroe St
Suite D
Sylvania, OH 43560-2265
Phone (419) 475-6605

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4212OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Marra, Optometrist, LLC Corneal and Contact Management CurrentSince Jan 2, 2015 Accepting new patients

Locations

5834 Monroe St
Ste D
Sylvania, OH 43560
Phone (419) 475-6605

4240 Secor Rd
Toledo, OH 43623
Phone (419) 475-6605

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, 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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1831194869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 SECOR ROAD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234238",
            "telephone_number": "419-475-6605",
            "fax_number": "419-475-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 SECOR ROAD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234238",
            "telephone_number": "419-475-6605",
            "fax_number": "419-475-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRA",
        "first_name": "JOSEPH",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OH",
            "license": "4212",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OH",
            "license": "4212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0504387",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.