Individual provider Active NPI

Gregory Theodore Komm, O.D.

  • Specialist
  • Bethesda, MD
National Provider Identifier
1083774368
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
TA1193 Issued in MD
Practice address
111 N Brook LN
Bethesda, MD 20814-2610
Phone
(301) 654-7180
Fax
(301) 664-9691
NPI assigned
Dec 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X TA1193 MD Primary

Addresses

Primary practice location

111 N Brook LN
Bethesda, MD 20814-2610

Mailing address

111 N Brook LN
Bethesda, MD 20814-2610
Phone (301) 654-7180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20120130000617 DC Practitioner - Optometry 8628235991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

718 Ctr Point Way
Gregory T Komm OD PA
Gaithersburg, MD 20878-6469
Phone (301) 990-0398

Merit-based Incentive Payment System (MIPS)

Final score
7.5 of 100Reported as individual
Quality
15
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Komm Medical Eye & Vision Group, LTD. CurrentSince Jul 27, 2011 Accepting new patients

Locations

718 Center Point Way
#T
Gaithersburg, MD 20878
Phone (301) 990-0398

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": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083774368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N BROOK LN",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208142610",
            "telephone_number": "301-654-7180",
            "fax_number": "301-664-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N BROOK LN",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208142610",
            "telephone_number": "301-654-7180",
            "fax_number": "301-664-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMM",
        "first_name": "GREGORY",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "TA1193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.