Active NPI
Marty J Wyman, O.D.
- Optometrist
- Westminster, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TA808
- Practice address
- 625 Baltimore Blvd
Westminster, MD 21157-6178 - Phone
- (410) 848-5442
- Fax
- (410) 848-5578
- NPI assigned
- Sep 25, 2006
- Last updated
- Jan 31, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TA808 | MD | Primary |
Addresses
Primary practice location
625 Baltimore Blvd
Westminster, MD 21157-6178
Mailing address
1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899
Other practice location 1
8200 Perry Hall Blvd
Baltimore, MD 21236-4901
Phone (410) 931-0923
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
625 Baltimore Blvd
Suite K
Westminster, MD 21157-6183
Phone (410) 848-5442
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TA808 | MD | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myeyedr Optometry of Maryland, LLC | Optometrist | Current | Accepting new patients |
| Canton Crossing Optometry, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Maryland, LLC | Optometrist | Current | Accepting new patients |
| Silver Spring Optometry, LLC | Optometrist | Past | Accepting new patients |
Locations
3715 Boston St
Baltimore, MD 21224
Phone (443) 839-0335
2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919
625 Baltimore Blvd
Ste K
Westminster, MD 21157
Phone (410) 848-5422
1950 Old Gallows Rd
Ste 520
Vienna, VA 22182
8614 Westwood Center Dr
Fl 9
Vienna, VA 22182
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517356800000",
"number": "1164522264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1950 OLD GALLOWS RD STE 520",
"city": "VIENNA",
"state": "VA",
"postal_code": "221823970",
"telephone_number": "703-847-8899",
"fax_number": "866-795-4020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 BALTIMORE BLVD",
"city": "WESTMINSTER",
"state": "MD",
"postal_code": "211576178",
"telephone_number": "410-848-5442",
"fax_number": "410-848-5578"
}
],
"practiceLocations": [
{
"address_1": "8200 Perry Hall Blvd",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212364901",
"country_code": "US",
"telephone_number": "410-931-0923",
"fax_number": "410-931-3484",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WYMAN",
"first_name": "MARTY",
"middle_name": "J",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2018-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MD",
"license": "TA808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Westminster, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.