Individual provider Active NPI

Jeffrey J Marsh, OD

  • Optometrist
  • Oshkosh, WI
National Provider Identifier
1902884489
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2161 Issued in WI
Practice address
423 N Main St
Oshkosh, WI 54901
Phone
(920) 426-2020
Fax
(920) 235-3195
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2161 WI Primary

Addresses

Primary practice location

423 N Main St
Oshkosh, WI 54901

Mailing address

423 N Main St
Oshkosh, WI 54901
Phone (920) 426-2020

Other identifiers 1

IdentifierTypeStateIssuer
38529700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20061215000241 WI Practitioner - Optometry 9830198068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr J J Marsh LTDGroup PAC ID 9234137902, 3 clinicians

Practice addresses (Care Compare)

2510 W 9TH Ave
Oshkosh, WI 54904-8125
Phone (920) 426-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2161WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dr J J Marsh LTD Optometrist CurrentSince Oct 1, 1991 Accepting new patients

Locations

423 N Main St
Oshkosh, WI 54901
Phone (920) 426-2020

2510 W 9th Ave
Oshkosh, WI 54904
Phone (920) 426-2020

908 E Main St
Ste A
Winneconne, WI 54986
Phone (920) 528-4477

Interoperability endpoints

  • Direct secure messaging: jeffrey.marsh@direct.revolutionehr.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1902884489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 N MAIN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54901",
            "telephone_number": "920-426-2020",
            "fax_number": "920-235-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 N MAIN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54901",
            "telephone_number": "920-426-2020",
            "fax_number": "920-235-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "JEFFREY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38529700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.