NPIMap

Organization Active NPI

Eye Clinic of Meridian PLLC

  • Ophthalmology Physician
  • Meridian, MS
National Provider Identifier
1942285564
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE CLINIC OF MERIDIAN PLLC
Practice address
1301 20TH Ave
Meridian, MS 39301-4121
Phone
(601) 485-2368
Fax
(601) 693-2174
NPI assigned
Dec 7, 2005
Last updated
May 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Authorized official

Name
Dr. Don E Marascalco, MDNPI 1649294935
Title
Senior Partner
Phone
(601) 485-2368

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

1301 20TH Ave
Meridian, MS 39301-4121

Mailing address

PO Box 1551
Meridian, MS 39302-1551
Phone (601) 485-2368

Other identifiers 9

IdentifierTypeStateIssuer
180041975OtherALDR MASON-RR MEDICARE
00116589MedicaidMS
00880212MedicaidMS
051550436MedicaidAL
180041976OtherALDR MARASCALCO-RR MEDICARE
009943235MedicaidAL
051554358OtherALDR JOHNSON-RR MEDICARE
051550437MedicaidAL
00116642MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031212000377 AL Part B Supplier - Clinic/Group Practice 8426954082 Receives reassigned benefits from 4 practitioners
Practice locations: Butler, AL
O20050302000922 MS Part B Supplier - Clinic/Group Practice 8426954082 Receives reassigned benefits from 3 practitioners
Practice locations: Meridian, MS

National Provider Directory

National Provider Directory

Locations

130 N Mulberry Ave
Butler, AL 36904
Phone (205) 459-2460

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1942285564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1551",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393021551",
            "telephone_number": "601-485-2368",
            "fax_number": "601-693-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 20TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014121",
            "telephone_number": "601-485-2368",
            "fax_number": "601-693-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CLINIC OF MERIDIAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-07",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "MARASCALCO",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "601-485-2368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR MASON-RR MEDICARE",
            "identifier": "180041975",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116589",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880212",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051550436",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR MARASCALCO-RR MEDICARE",
            "identifier": "180041976",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009943235",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR JOHNSON-RR MEDICARE",
            "identifier": "051554358",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051550437",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116642",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.