Organization Active NPI

Eye RX PLLC

  • Optometrist
  • Chevy Chase, MD
National Provider Identifier
1073928800
Registry record updated Apr 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2244 Issued in MD
Legal business name
EYE RX PLLC
Practice address
4600 N Park Ave
Plaza North
Chevy Chase, MD 20815-4518
Phone
(301) 841-6776
Fax
(301) 215-4144
NPI assigned
Jul 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2016

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

Authorized official

Name
Benjamin M. Teller, ODNPI 1447282702
Title
Owner
Phone
(301) 841-6776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TA2244 MD Primary

Addresses

Primary practice location

4600 N Park Ave
Plaza North
Chevy Chase, MD 20815-4518

Mailing address

4600 N Park Ave
Plaza North
Chevy Chase, MD 20815-4518
Phone (301) 841-6776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141119000440 DC Part B Supplier - Clinic/Group Practice 8123240546 Receives reassigned benefits from 2 practitioners
Practice locations: Chevy Chase, MD; Washington, DC

National Provider Directory

National Provider Directory

Locations

1629 K St NW
Ste 502
Washington, DC 20006
Phone (202) 659-2010

4600 N Park Ave
Ste Plzs
North Chevy Chase, MD 20815
Phone (301) 841-6776

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460073600000",
    "number": "1073928800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 N PARK AVE",
            "address_2": "PLAZA NORTH",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154518",
            "telephone_number": "301-841-6776",
            "fax_number": "301-215-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 N PARK AVE",
            "address_2": "PLAZA NORTH",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154518",
            "telephone_number": "301-841-6776",
            "fax_number": "301-215-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE RX PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-01",
        "last_updated": "2016-04-08",
        "status": "A",
        "authorized_official_last_name": "TELLER",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-841-6776",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; 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.