Individual provider Active NPI

Julie Fitzgerald

  • Optometrist
  • Glen Burnie, MD
National Provider Identifier
1013139815
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1634 Issued in MD
Practice address
806 Landmark Dr
Ste 114
Glen Burnie, MD 21061-4966
Phone
(410) 590-9260
Fax
(410) 590-9266
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1634 MD Primary

Addresses

Primary practice location

806 Landmark Dr
Ste 114
Glen Burnie, MD 21061-4966

Mailing address

806 Landmark Dr
Ste 114
Glen Burnie, MD 21061-4966

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110125000554 DC Practitioner - Optometry 8426112392 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paul a Tarantino, M.D.,P.a. CurrentSince Feb 2, 2016 Accepting new patients
WHC Physician Group LLC CurrentSince Jun 22, 2015 Accepting new patients
WHC Emerg Phys CurrentSince Jun 22, 2015 Accepting new patients
Capital Eye Physicians & Surgeons LLC Past Accepting new patients
Capital Eye Physicians & Surgeons, LLC Past Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

4000 Mitchellville Rd
Ste B128
Bowie, MD 20716
Phone (301) 464-1192

806 Landmark Dr
Ste 114
Glen Burnie, MD 21061
Phone (410) 590-9260

8630 Fenton St
Ste 7
Silver Spring, MD 20910
Phone (301) 565-0222

Organizations & group practices 5

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1013139815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 LANDMARK DR",
            "address_2": "STE 114",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 LANDMARK DR",
            "address_2": "STE 114",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614966",
            "telephone_number": "410-590-9260",
            "fax_number": "410-590-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "JULIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.