Individual provider Active NPI

Bao Le, OD

  • Optometrist
  • Dundalk, MD
National Provider Identifier
1033842901
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2863 Issued in MD
Practice address
1748 Merritt Blvd Ste B
Dundalk, MD 21222-3212
Phone
(443) 530-6381
NPI assigned
Jul 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 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 TA2863 MD Primary

Addresses

Primary practice location

1748 Merritt Blvd Ste B
Dundalk, MD 21222-3212

Mailing address

301 Temple CT
Bel Air, MD 21015-6163

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
I20241025002471 MD Practitioner - Optometry 3577096742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
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)

7684 Belair Rd
Baltimore, MD 21236-4088
Phone (410) 486-1010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA2863MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates of MD, LLC Optometrist CurrentSince Aug 16, 2024 Accepting new patients

Locations

517 E Belvedere Ave
Baltimore, MD 21212
Phone (410) 323-1515

1748 Merritt Blvd
Ste B
Dundalk, MD 21222
Phone (443) 530-6381

7684 Belair Rd
Nottingham, MD 21236
Phone (410) 882-9600

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

8109 Harford Rd
Ste G
Parkville, MD 21234

Interoperability endpoints

  • Direct secure messaging: bao.le.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": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1033842901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 TEMPLE CT",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210156163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1748 MERRITT BLVD STE B",
            "city": "DUNDALK",
            "state": "MD",
            "postal_code": "212223212",
            "telephone_number": "443-530-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "BAO",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dundalk, MD

Sources for this page

Verify at the official NPI Registry.