Individual provider Active NPI

Perry J Lucente, OD

  • Optometrist
  • Davidsonville, MD
National Provider Identifier
1003973538
Registry record updated Mar 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1029 Issued in MD
Practice address
2510 Howard Grove Rd
Davidsonville, MD 21035
Phone
(410) 956-2594
Fax
(410) 956-2594
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1029 MD Primary
Optometrist 152W00000X 0601001619 VA

Addresses

Primary practice location

2510 Howard Grove Rd
Davidsonville, MD 21035

Mailing address

2510 Howard Grove Rd
Davidsonville, MD 21035
Phone (410) 956-2594

Other identifiers 3

IdentifierTypeStateIssuer
650898700MedicaidMD
656342OtherMDMEDICARE
656342OtherDCMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080624000322 DC Practitioner - Optometry 3870664527 Practice locations: Davidsonville, MD
I20110119000812 MD Practitioner - Optometry 3870664527 Reassigns benefits to 1 organization
Practice locations: Davidsonville, MD

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyes on You, LLCGroup PAC ID 2264662204, 3 clinicians

Practice addresses (Care Compare)

10335 Southern Maryland Blvd
Dunkirk, MD 20754-3051
Phone (443) 964-6730

Merit-based Incentive Payment System (MIPS)

Final score
84.71 of 100Reported as group
Quality
69.42
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA1029MDMDOptometrist
0601001619VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Prince Frederick Optometry, LLC Optometrist CurrentSince Aug 17, 2014 Accepting new patients
Eyes on You, LLC Optometrist CurrentSince Dec 4, 2013 Accepting new patients

Locations

10335 Southern Maryland Blvd
Ste 102
Dunkirk, MD 20754
Phone (410) 533-7763

10335 Southern Maryland Blvd
Ste 1
Dunkirk, MD 20754
Phone (443) 964-6730

10335 Southern Maryland Blvd
Dunkirk, MD 20754

162 W Dares Beach Rd
Prnc Frederck, MD 20678
Phone (410) 474-1363

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268524800000",
    "number": "1003973538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 HOWARD GROVE RD",
            "city": "DAVIDSONVILLE",
            "state": "MD",
            "postal_code": "21035",
            "telephone_number": "410-956-2594",
            "fax_number": "410-956-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 HOWARD GROVE RD",
            "city": "DAVIDSONVILLE",
            "state": "MD",
            "postal_code": "21035",
            "telephone_number": "410-956-2594",
            "fax_number": "410-956-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCENTE",
        "first_name": "PERRY",
        "middle_name": "J",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2010-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1029",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601001619",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "650898700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "656342",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "656342",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davidsonville, MD

Sources for this page

Verify at the official NPI Registry.