NPIMap

Organization Active NPI

Capital Eye Physicians & Surgeons, LLC

  • Ophthalmology Physician
  • Bowie, MD
National Provider Identifier
1154451219
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CAPITAL EYE PHYSICIANS & SURGEONS, LLC
Practice address
4000 Mitchellville Rd
Suite B-128
Bowie, MD 20716-3104
Phone
(301) 809-6305
Fax
(301) 809-6306
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Authorized official

Name
Mrs. Wendy D Kautz, CSA
Title
Administrator
Phone
(301) 809-6305

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

4000 Mitchellville Rd
Suite B-128
Bowie, MD 20716-3104

Mailing address

4000 Mitchellville Rd
Suite B-128
Bowie, MD 20716-3104
Phone (301) 809-6305

Other identifiers 2

IdentifierTypeStateIssuer
689701103MedicaidMD
689701100MedicaidMD

National Provider Directory

National Provider Directory

Locations

6201 Greenbelt Rd
Ste M8
Berwyn Heights, MD 20740
Phone (301) 313-9013

Practitioners & affiliated clinicians

Practitioners 10

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": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1154451219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD",
            "address_2": "SUITE B-128",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163104",
            "telephone_number": "301-809-6305",
            "fax_number": "301-809-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD",
            "address_2": "SUITE B-128",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163104",
            "telephone_number": "301-809-6305",
            "fax_number": "301-809-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL EYE PHYSICIANS & SURGEONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "KAUTZ",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "301-809-6305",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CSA"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "689701103",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "689701100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.