Individual provider Active NPI

Tricia Stachecki, O.D.

  • Optometrist
  • Elkton, MD
National Provider Identifier
1073705604
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2056 Issued in MD
Practice address
360 E Pulaski Hwy
Elkton, MD 21921-6457
Phone
(410) 398-5240
Fax
(410) 398-4762
NPI assigned
Aug 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2056 MD Primary

Addresses

Primary practice location

360 E Pulaski Hwy
Elkton, MD 21921-6457

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • Tricia Marie Hanyok 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
I20071113000677 MD Practitioner - Optometry 9032207717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2007
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)

1 Newport Dr J
Forest Hill, MD 21050-1659
Phone (410) 838-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Jul 17, 2015 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Jul 17, 2015 Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients

Locations

951F Beards Hill Rd
Aberdeen, MD 21001
Phone (410) 272-1800

6306 York Rd
#1-2
Baltimore, MD 21212
Phone (443) 863-5206

5 Bel Air South Pkwy
Ste 117
Bel Air, MD 21015
Phone (410) 569-0500

360 E Pulaski Hwy
Ste 1B
Elkton, MD 21921
Phone (410) 398-5240

1 Newport Dr
Ste J
Forest Hill, MD 21050
Phone (410) 838-3200

920 Revolution St
Hvre de Grace, MD 21078
Phone (410) 939-2200

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

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 4

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": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1073705604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "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": "360 E PULASKI HWY",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216457",
            "telephone_number": "410-398-5240",
            "fax_number": "410-398-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACHECKI",
        "first_name": "TRICIA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-17",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRICIA",
            "last_name": "HANYOK",
            "middle_name": "MARIE",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elkton, MD

Sources for this page

Verify at the official NPI Registry.