Individual provider Active NPI

Alexander Earl Carpenter, O.D.

  • Optometrist
  • Salisbury, MD
National Provider Identifier
1154761435
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2362 Issued in MD
Practice address
409 N Fruitland Blvd
Salisbury, MD 21801-7201
Phone
(410) 341-7403
NPI assigned
Jul 1, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2362 MD Primary

Addresses

Primary practice location

409 N Fruitland Blvd
Salisbury, MD 21801-7201

Mailing address

210 Marlboro Ave
Suite 31
Easton, MD 21601-2765
Phone (410) 822-3937

Other practice location 1

210 Marlboro Ave
Suite 31
Easton, MD 21601-2765
Phone (410) 822-3937

Other identifiers 1

IdentifierTypeStateIssuer
418419000MedicaidMD

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
I20130819000060 MD Practitioner - Optometry 1850533019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2775 Dorchester SQ
Cambridge, MD 21613-6400
Phone (410) 221-0284

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA2362MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ac Optometry Optometrist CurrentSince Mar 1, 2020 Accepting new patients

Locations

2775 Dorchester Sq
Cambridge, MD 21613
Phone (410) 221-0284

409 N Fruitland Blvd
Salisbury, MD 21801
Phone (410) 341-6208

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": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1154761435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 MARLBORO AVE",
            "address_2": "SUITE 31",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216012765",
            "telephone_number": "410-822-3937",
            "fax_number": "410-822-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 N FRUITLAND BLVD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017201",
            "telephone_number": "410-341-7403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Marlboro Ave",
            "address_2": "Suite 31",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "MD",
            "postal_code": "216012765",
            "country_code": "US",
            "telephone_number": "410-822-3937",
            "fax_number": "410-822-2652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "ALEXANDER",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-01",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "418419000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.