NPIMap

Organization Active NPI

Eye Care and Surgery PA

  • Ophthalmology Physician
  • Laurel, MD
National Provider Identifier
1114157666
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D69502 Issued in MD
Legal business name
EYE CARE AND SURGERY PA
Practice address
8311 Cherry LN
Laurel, MD 20707-4830
Phone
(301) 604-2010
Fax
(301) 490-3768
NPI assigned
Jul 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Authorized official

Name
Joseph Qureshi, M.D.NPI 1992971519
Title
Owner
Phone
(301) 604-2010

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X D69502 MD Primary

Addresses

Primary practice location

8311 Cherry LN
Laurel, MD 20707-4830

Mailing address

8311 Cherry LN
Laurel, MD 20707-4830
Phone (301) 604-2010

Other identifiers 4

IdentifierTypeStateIssuer
161848OtherDCMEDICARE
DS8380OtherGARAILROAD MEDICARE
S616-0001OtherDCCAREFIRST
S616-0001OtherMDCAREFIRST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090915000209 DC Part B Supplier - Clinic/Group Practice 0840346946 Receives reassigned benefits from 3 practitioners
Practice locations: Laurel, MD; Riverdale, MD
O20110324000035 MD Part B Supplier - Clinic/Group Practice 0840346946 Receives reassigned benefits from 2 practitioners
Practice locations: Cumberland, MD; Bethesda, MD

National Provider Directory

National Provider Directory

Locations

6011 University Blvd
Ste 190
Ellicott City, MD 21043
Phone (301) 604-2010

8311 Cherry Ln
Laurel, MD 20707
Phone (301) 604-2010

Practitioners & affiliated clinicians

Practitioners 4

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": "1247788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375056000000",
    "number": "1114157666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8311 CHERRY LN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074830",
            "telephone_number": "301-604-2010",
            "fax_number": "301-490-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8311 CHERRY LN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074830",
            "telephone_number": "301-604-2010",
            "fax_number": "301-490-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE AND SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-17",
        "last_updated": "2013-07-29",
        "status": "A",
        "authorized_official_last_name": "QURESHI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-604-2010",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D69502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "161848",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DS8380",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "S616-0001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "S616-0001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.