Individual provider Active NPI

Deanne Leonard, OD

  • Optometrist
  • Baltimore, MD
National Provider Identifier
1003902016
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1862 Issued in MD
Practice address
3506 Ellamont Rd
Baltimore, MD 21215
Phone
(443) 802-9920
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1862 MD Primary

Addresses

Primary practice location

3506 Ellamont Rd
Baltimore, MD 21215

Mailing address

3506 Ellamont Rd
Baltimore, MD 21215
Phone (443) 802-9920

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040514000983 MD Practitioner - Optometry 7315937950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Vision Eyecare IncGroup PAC ID 8022322106, 4 clinicians

Practice addresses (Care Compare)

9613 Harford Rd
Suite I
Baltimore, MD 21234-2150
Phone (410) 665-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Deanne Leonard OD LLC Optometrist CurrentSince Sep 14, 2009 Accepting new patients
Professional Vision Eyecare Inc Optometrist CurrentSince Jun 8, 2024 Accepting new patients

Locations

9613 Harford Rd
Ste I
Parkville, MD 21234
Phone (410) 665-6200

2147 York Rd
Timonium, MD 21093
Phone (410) 252-3100

Interoperability endpoints

  • Direct secure messaging: deanne.leonard.p1@direct.nri.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1003902016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3506 ELLAMONT RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21215",
            "telephone_number": "443-802-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 ELLAMONT RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21215",
            "telephone_number": "443-802-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "DEANNE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.