Mr Mark A Latta, OD in Fort Defiance, AZ - Medicare Optometrist Provider

Mr Mark A Latta, OD is a medicare enrolled "Optometrist" provider in Fort Defiance, Arizona. His current practice location is Corner Of Route N12 And N7, Fort Defiance, Arizona. You can reach out to his office (for appointments etc.) via phone at (928) 729-8925.

Mr Mark A Latta is licensed to practice in Texas (license number 2728TG) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1609865872.

Contact Information

	Mr Mark A Latta, OD
	Corner Of Route N12 And N7, Fort Defiance, AZ 86504
	(928) 729-8925
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Mark A Latta
Gender	Male
Speciality	Optometrist
Location	Corner Of Route N12 And N7, Fort Defiance, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1609865872
Provider Enumeration Date: 10/19/2005
Last Update Date: 06/13/2019

Medicare PECOS Information:

PECOS PAC ID: 5395852115
Enrollment ID: I20111107000405

Medical Identifiers

Medical identifiers for Mr Mark A Latta such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1609865872	NPI	-	NPPES
410039483	Other	TX	RAILROAD MEDICARE
89X292	Other	TX	BC/BS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	2728TG (Texas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Mark A Latta allows following entities to bill medicare on his behalf.

Provider Name	Dhhs Phs Naihs Shiprock Hospital
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1780639971 PECOS PAC ID: 0749193837 Enrollment ID: O20031105000809

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Mark A Latta is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Mark A Latta, OD 4140 Marla Dr Ne, Albuquerque, NM 87109-1983 Ph: () -	Mr Mark A Latta, OD Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Ph: (928) 729-8925

Reviews and Comments

Optometrist in Fort Defiance, AZ

Dr. Melissa Marie Lester, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8929
Dr. Luisa Rahell Alvarez, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: Corner Of Route N12 And N7, Fort Defiance Hospital Board, Inc., Fort Defiance, AZ 86504 Phone: 951-312-9596
Ryan Nguyen, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: Indian Rte 7 & Indian Route 12, Fort Defiance, AZ 86504 Phone: 928-729-8000
Colby Barton, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: P.o. Box 649 Route N12 And N7, Tsehootsooi Medical Center, Fort Defiance, AZ 86504 Phone: 928-729-8925
Dr. Melissa Marie Walters, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8000
Dr. Michelle Marie Go Mijares, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8000

Mr Mark A Latta, OD - Medicare Optometrist in Fort Defiance, AZ