Individual provider Active NPI

Thomas Jacob Vaxmonsky, O.D.

  • Optometrist
  • Frederick, MD
National Provider Identifier
1043370828
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MDTA0999 Issued in MD
Practice address
5500 Buckeystown Pike Ste 620
Frederick, MD 21703-9458
Phone
(301) 663-4745
Fax
(301) 293-0256
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X MDTA0999 MD Primary

Addresses

Primary practice location

5500 Buckeystown Pike Ste 620
Frederick, MD 21703-9458

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other identifiers 1

IdentifierTypeStateIssuer
31444OtherMDUNITEDHEALTHCARE

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
I20110303000440 DC Practitioner - Optometry 2860674413 Reassigns benefits to 1 organization
I20191218000033 MD Practitioner - Optometry 2860674413 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Maryland LLCGroup PAC ID 6002037629, 121 clinicians

Practice addresses (Care Compare)

5500 Buckeystown Pike
Suite 620
Frederick, MD 21703-9458
Phone (301) 663-4745

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Urbana Eye Care LLC Optometrist CurrentSince Mar 1, 2020 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Sep 27, 2021 Accepting new patients
Eye Design, Inc Optometrist CurrentSince Nov 10, 2019 Accepting new patients
Shady Grove Eye & Vision Care, LLC Optometrist CurrentSince Nov 10, 2019 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Sep 27, 2021 Accepting new patients
My Eye Dr. Optometrists, LLC Optometrist Past Accepting new patients
Dr Alan N Glazier Optometrist PA Optometrist PastSince Nov 10, 2019 Accepting new patients
Baran & Duan PA Optometrist PastSince Jan 1, 2025 Accepting new patients

Locations

7801 Old Branch Ave
Ste 103
Clinton, MD 20735
Phone (301) 868-9090

6455 Dobbin Rd
Ste 47
Columbia, MD 21045
Phone (443) 542-5999

1311 Londontown Blvd
Ste 100
Eldersburg, MD 21784
Phone (410) 795-5588

8925 Fingerboard Rd
Ste E
Frederick, MD 21704
Phone (301) 810-5104

5500 Buckeystown Pike
Ste 620
Frederick, MD 21703
Phone (301) 663-4745

7810 Wormans Mill Rd
Ste C
Frederick, MD 21701
Phone (301) 228-2666

1725B Dual Hwy
Hagerstown, MD 21740
Phone (301) 739-6573

1809 Reisterstown Rd
Pikesville, MD 21208
Phone (410) 484-6348

15200 Shady Grove Rd
Ste 100
Rockville, MD 20850
Phone (301) 670-1212

2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: thomas.vaxmonsky@uprisedirect.com

Organizations & group practices 9

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1043370828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 BUCKEYSTOWN PIKE STE 620",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217039458",
            "telephone_number": "301-663-4745",
            "fax_number": "301-293-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAXMONSKY",
        "first_name": "THOMAS",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "MDTA0999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "31444",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.