DR. JOHN R MARKHAM O D
NPI 1225094550
Optometrist in Prescott, AZ

Active since April 25, 2006PECOS EnrolledAccepts Medicare Assignment
87.65/100
CMS Quality Rating
1680 WILLOW CREEK RD, PRESCOTT, AZ 86301(928) 778-3950(928) 778-3999 Get Directions Write a Review

NPPES record last updated: April 20, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. John R Markham O D NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOHN R MARKHAM O D (NPI 1225094550) is an individual optometrist in Prescott, Arizona, licensed in Arizona (142) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS and is a graduate of Pacific University - College Of Optometry (1973).

NPPES Registry Identity

NPI1225094550
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. JOHN R MARKHAMCredential: O D
Location Address1680 WILLOW CREEK RDPrescott, AZ 86301-1108
Mailing Address3192 Willow Creek RdPrescott, AZ 86301-6610 · (928) 778-3950 · Fax (928) 778-3999
Fax(928) 778-3999
Sole ProprietorYes
Medical School CMSPacific University - College Of OptometryGraduated 1973
Enumeration DateApril 25, 2006
Last NPPES UpdateApril 20, 2016
NPI 1225094550 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License Licensed in AZ · 142
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
1680 WILLOW CREEK RD, Prescott, AZ 86301

Other Identifiers 17

Other5858351Aetna
OtherAZ0142Eyemed
OtherZ63118AZ · Group Medicare - Clinic
Other15220Avesis
Other866291-9714Humana
Other1263119AZ · Mercycare
OtherDM2NNPArizona Foundation
OtherAZ0142Eyecare Direct
Other153165Ran & Amn
Other3Z0277AZ · Health Net
Other033176AZ · Ahcccs
OtherAZ01170AZ · Medicare Submitter Id - Clinic
OtherNNP12599AZ · Universal Health Care
Medicaid033176AZ
Medicare NSC0384690001AZ
Medicare PINOD142AZ
Medicare UPINT 41904AZ

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. John R Markham O D is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971595919
PECOS Enrollment IDI20051102000049
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
66 services59 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
34 services34 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
32 services32 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
26 services25 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.65/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Promoting Interoperability100
Improvement Activities40
Cost58.84

Reported Quality Measures

Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
94%53 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Eyewear Supplier
1680 WILLOW CREEK RD
PRESCOTT, AZ 86301
Clinic/Center (Ambulatory Surgical)
1680 WILLOW CREEK RD
PRESCOTT, AZ 86301
Optometrist
1680 WILLOW CREEK RD
PRESCOTT, AZ 86301
Optometrist
1680 WILLOW CREEK RD
PRESCOTT, AZ 86301
Nurse Anesthetist, Certified Registered
1680 WILLOW CREEK RD
PRESCOTT, AZ 86301
Clinic/Center (Urgent Care)
1680 WILLOW CREEK RD
PRESCOTT, AZ 86301
Optometrist
1680 WILLOW CREEK RD
PRESCOTT, AZ 86301
Ophthalmology
1680 WILLOW CREEK RD
PRESCOTT, AZ 86301

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Markham's NPI number?

The NPI number for John Markham is 1225094550. It was assigned to this individual provider in the NPPES registry on April 25, 2006.

Where is John Markham located?

John Markham practices at 1680 Willow Creek Rd, Prescott, AZ 86301. The listed phone number is (928) 778-3950.

What is John Markham's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is John Markham enrolled in Medicare?

Yes. John Markham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does John Markham accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Imperial Insurance Companies, Inc. and 3 other insurers list John Markham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for John Markham was last updated on April 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.