Active NPI
Tracie M King, O.D.
- Optometrist
- Elkridge, MD
National Provider Identifier
1003801077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TA1597
- Practice address
- 7310 Esquire CT Ste 3
Bay Family Eye Care
Elkridge, MD 21075-5440 - Phone
- (410) 796-4555
- Fax
- (410) 796-8606
- NPI assigned
- Sep 15, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TA1597 | MD | Primary |
Addresses
Primary practice location
7310 Esquire CT Ste 3
Bay Family Eye Care
Elkridge, MD 21075-5440
Mailing address
7310 Esquire CT Ste 3
Bay Family Eye Care
Elkridge, MD 21075-5440
Phone (410) 796-4555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Ferris State College - College of Optometry, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7310 Esquire CT
Suite 3
Elkridge, MD 21075-5441
Phone (410) 796-4555
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- https://api.platform.athenahealth.com/19517/brand/1/csg/1/fhir/r4
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Elkridge, MD
- NPI 1215110564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696550400000",
"number": "1003801077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7310 ESQUIRE CT STE 3",
"address_2": "BAY FAMILY EYE CARE",
"city": "ELKRIDGE",
"state": "MD",
"postal_code": "210755440",
"telephone_number": "410-796-4555",
"fax_number": "410-796-8606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7310 ESQUIRE CT STE 3",
"address_2": "BAY FAMILY EYE CARE",
"city": "ELKRIDGE",
"state": "MD",
"postal_code": "210755440",
"telephone_number": "410-796-4555",
"fax_number": "410-796-8606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "TRACIE",
"middle_name": "M",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-09-15",
"last_updated": "2023-10-06",
"certification_date": "2023-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MD",
"license": "TA1597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkridge, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.