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MAREENA ROUFAIL OD
NPI 1457963910
Optometrist in Berkeley, CA

Active since August 17, 2020PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
3100 SAN PABLO AVE, BERKELEY, CA 94702(510) 985-5100(510) 985-5223 Get Directions Write a Review

NPPES record last updated: August 5, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 5, 2022, Aug 17, 2020 (2 updates tracked since 2020).

About Mareena Roufail Od NPPES

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

MAREENA ROUFAIL OD (NPI 1457963910) is an individual optometrist in Berkeley, California, licensed in California (34899) and active in the NPI registry since August 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1457963910
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameMAREENA ROUFAILCredential: OD
Location Address3100 SAN PABLO AVEBerkeley, CA 94702-2498
Mailing Address3100 San Pablo AveBerkeley, CA 94702-2498 · (510) 985-5100 · Fax (510) 985-5223
Phone(510) 985-5100
Fax(510) 985-5223
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateAugust 17, 2020
Last NPPES UpdateAugust 5, 20222 updates tracked since enumeration
NPPES CertifiedAugust 5, 2022
✔ NPI 1457963910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in CA · 34899✔ Licensed in WA · OD61092875
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.
3100 SAN PABLO AVE, Berkeley, CA 94702
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.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

Mareena Roufail Od 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 ID2567882764
PECOS Enrollment IDI20220727001279
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.

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
211 services211 patients
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212
This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
211 services196 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
19 services19 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.
18 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94702 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
$153.83 typical visit price
range $69.00 – $202.35
Typical copayment $38.45 (range $17.25 – $50.58)
Most-billed visit code 99204
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Other Providers at the Same Location NPPES 2

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

DR. MELISSA NEUWELT M.D.
Ophthalmology
3100 SAN PABLO AVE
BERKELEY, CA 94702
Alameda County (510) 985-5100
WHITNEY KARR BROWN NP
Nurse Practitioner (Family)
3100 SAN PABLO AVE
BERKELEY, CA 94702
Alameda County (510) 420-8000

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 Mareena Roufail's NPI number?

The NPI number for Mareena Roufail is 1457963910. It was assigned to this individual provider in the NPPES registry on August 17, 2020.

Where is Mareena Roufail located?

Mareena Roufail practices at 3100 San Pablo Ave, Berkeley, CA 94702. The listed phone number is (510) 985-5100.

What is Mareena Roufail's specialty?

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

Is Mareena Roufail enrolled in Medicare?

Yes. Mareena Roufail 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 Mareena Roufail accept?

Health plans from Providence Health Plan list Mareena Roufail 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 Mareena Roufail was last updated on August 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.