Mark Leroy Davis, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1888 Issued in IA

Practice address

3333 Dubuque Ave
Des Moines, IA 50317-2767

Phone

(515) 630-2875

Fax

(156) 302-8765

NPI assigned

Feb 2, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IA

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

Illinois College of Optometry at Chicago, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Real Optics Inc 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

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.

• Real Optics Inc

  • Eyewear Supplier
  • Des Moines, IA
  • NPI 1003970344

  IA

  Medicare reassignment Care Compare group NPD
• Semrow Family Vision, PC

  • Optometrist
  • Ankeny, IA
  • NPI 1073184339

  IA, Optometrist

  Medicare reassignment NPD
• Mark L Davis OD LLC

  • Optometrist
  • Altoona, IA
  • NPI 1922676865
  NPD Authorized official
• Total Eye Health Center Inc

  • Optometrist
  • Anamosa, IA
  • NPI 1629194816
  NPD (past) Authorized official
• Real Optics Inc

  • Eyewear Supplier
  • Mason City, IA
  • NPI 1407065261
  NPD (past)

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1881666014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 DUBUQUE AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503172767",
            "telephone_number": "515-630-2875",
            "fax_number": "515-630-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 DUBUQUE AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503172767",
            "telephone_number": "515-630-2875",
            "fax_number": "156-302-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MARK",
        "middle_name": "LEROY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "28826",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00400423",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0288266",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beverly Anne Davis, NP
• Cynthia A Davis, LMHC,NCC,CCCJS
• Falycia Dawn Davis, LMSW
• Kathleen Carol Davis, FNP
• Logan Davis
• Scott R Davison, M.D.
• Bruce Lee Dawson, PSY.D.
• Bryana Dawson, PSYCHOLOGY B.A.
• Magdalena Tatiana Dawson, APRN
• Steven T Dawson, M.D.

• All providers in Des Moines, IA
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.