Looking Glass Optical Contacts and Eyeglasses

Primary specialty

OptometristTaxonomy code 152W00000X

License

TA0974 Issued in MD

Legal business name

LOOKING GLASS OPTICAL CONTACTS AND EYEGLASSES

Practice address

8028 Ritchie Hwy
Suite 124
Pasadena, MD 21122-1075

Phone

(410) 768-0202

Fax

(410) 768-1330

NPI assigned

Jan 5, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Richard Marc Teles, ABOC

Title

President Owner

Phone

(410) 768-0202

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mayer Joseph Teles, OD

  • Optometrist
  • Pasadena, MD
  • NPI 1659560621
  Medicare reassignment NPD

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073660452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8028 RITCHIE HWY",
            "address_2": "SUITE 124",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211221075",
            "telephone_number": "410-768-0202",
            "fax_number": "410-768-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8028 RITCHIE HWY",
            "address_2": "SUITE 124",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211221075",
            "telephone_number": "410-768-0202",
            "fax_number": "410-768-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOOKING GLASS OPTICAL CONTACTS AND EYEGLASSES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TELES",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "410-768-0202",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ABOC"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA0974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF DC",
            "identifier": "T1680001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "603673",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF MARYLAND",
            "identifier": "KEN4LO",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Pasadena, MD
• Providers in Pasadena, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.