Organization Active NPI

Crofton Family Eye Care LLC

  • Optometrist
  • Crofton, MD
National Provider Identifier
1003127887
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1908 Issued in MD
Legal business name
CROFTON FAMILY EYE CARE LLC
Practice address
1702 Transportation Blvd Ste I
Crofton, MD 21114-2149
Phone
(410) 721-2500
Fax
(410) 721-1308
NPI assigned
Jun 28, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
Nghi Nina Nguyen Phuong DoyleNPI 1578524088
Title
Optometrist Owner
Phone
(410) 721-2500

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TA1908 MD Primary

Addresses

Primary practice location

1702 Transportation Blvd Ste I
Crofton, MD 21114-2149

Mailing address

1702 Transportation Blvd Ste I
Crofton, MD 21114-2149
Phone (410) 721-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101015000916 MD Part B Supplier - Clinic/Group Practice 9335332824 Receives reassigned benefits from 3 practitioners
Practice locations: Crofton, MD

National Provider Directory

National Provider Directory

Locations

1702 Transportation Blvd
Ste I
Crofton, MD 21114
Phone (410) 721-2500

2225 Defense Hwy
Ste C
Crofton, MD 21114
Phone (410) 721-2500

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1003127887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 TRANSPORTATION BLVD STE I",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142149",
            "telephone_number": "410-721-2500",
            "fax_number": "410-721-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 TRANSPORTATION BLVD STE I",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142149",
            "telephone_number": "410-721-2500",
            "fax_number": "410-721-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROFTON FAMILY EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-28",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "NGHI NINA",
        "authorized_official_middle_name": "NGUYEN PHUONG",
        "authorized_official_title_or_position": "OPTOMETRIST OWNER",
        "authorized_official_telephone_number": "410-721-2500"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.