Individual provider Active NPI

Samantha Renee Andreaggi, O.D.

  • Optometrist
  • Towson, MD
National Provider Identifier
1013357532
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA 2355 Issued in MD
Practice address
920 Providence Rd Ste 100
Towson, MD 21286-2976
Phone
(443) 394-8679
NPI assigned
Jun 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA 2355 MD Primary

Addresses

Primary practice location

920 Providence Rd Ste 100
Towson, MD 21286-2976

Mailing address

920 Providence Rd
Ste 100
Towson, MD 21286-2976
Phone (410) 486-1010

Other names 1

  • Dr. Samantha Renee House Former name

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
I20130829000583 MD Practitioner - Optometry 0547403131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Associates of Maryland LLCGroup PAC ID 1850491994, 22 clinicians

Practice addresses (Care Compare)

4313 Ebenezer Rd
Nottingham, MD 21236-2143

4830 Butler Rd
Glyndon, MD 21071-4209
Phone (410) 486-1010

8109 Harford Rd
Suite G
Parkville, MD 21234-9205
Phone (410) 486-1010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA 2355MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates of MD, LLC Optometrist CurrentSince Dec 2, 2019 Accepting new patients

Locations

4313 Ebenezer Rd
Nottingham, MD 21236
Phone (410) 529-1950

8109 Harford Rd
Ste G
Parkville, MD 21234

920 Providence Rd
Ste 100
Towson, MD 21286
Phone (443) 394-8679

Interoperability endpoints

  • Direct secure messaging: samantha.house.p1@direct.levineyecare.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1013357532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 PROVIDENCE RD",
            "address_2": "STE 100",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212862976",
            "telephone_number": "410-486-1010",
            "fax_number": "443-895-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 PROVIDENCE RD STE 100",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212862976",
            "telephone_number": "443-394-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREAGGI",
        "first_name": "SAMANTHA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA 2355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "HOUSE",
            "middle_name": "RENEE",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.