Individual provider Active NPI

Daniel L Markley, OD

  • Optometrist
  • Grand Blanc, MI
National Provider Identifier
1902971997
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003949 Issued in MI
Practice address
12606 Holly Rd
Grand Blanc, MI 48439-2447
Phone
(810) 694-3652
Fax
(810) 694-0963
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003949 MI Primary

Addresses

Primary practice location

12606 Holly Rd
Grand Blanc, MI 48439-2447

Mailing address

12606 Holly Rd
Grand Blanc, MI 48439-2447
Phone (810) 694-3652

Other identifiers 3

IdentifierTypeStateIssuer
0994958OtherMIHEALTH PLUS OF MI
900B563850OtherMIBCBS
4861189MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20110222000864 MI Practitioner - Optometry 8325079064 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holly Vision Clinic PCGroup PAC ID 4688919319, 3 clinicians
Grand Blanc Vision Clinic PCGroup PAC ID 9739119793, 4 clinicians
Iris Eyecare PCGroup PAC ID 9335478650, 2 clinicians

Practice addresses (Care Compare)

1121 N Saginaw St
Suite 1
Holly, MI 48442-1380
Phone (248) 382-5733

12606 Holly Rd
Grand Blanc, MI 48439-2447
Phone (810) 694-3652

403 S Leroy St
Fenton, MI 48430-2143
Phone (810) 694-3652

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Iris Eyecare PC Optometrist CurrentSince Aug 1, 2019 Accepting new patients
Grand Blanc Vision Clinic P.C. Optometrist CurrentSince Feb 3, 2003 Accepting new patients
Holly Vision Clinic PC Optometrist CurrentSince Nov 19, 2018 Accepting new patients

Locations

403 S Leroy St
Fenton, MI 48430
Phone (810) 694-3652

403 S Leroy St
Ste 1
Fenton, MI 48430

12606 Holly Rd
Grand Blanc, MI 48439
Phone (810) 694-3652

1121 N Saginaw St
Ste 1
Holly, MI 48442
Phone (248) 382-5733

Organizations & group practices 3

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1902971997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12606 HOLLY RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392447",
            "telephone_number": "810-694-3652",
            "fax_number": "810-694-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12606 HOLLY RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392447",
            "telephone_number": "810-694-3652",
            "fax_number": "810-694-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKLEY",
        "first_name": "DANIEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS OF MI",
            "identifier": "0994958",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "900B563850",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4861189",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.