NPIMap

Organization Active NPI

Komm Medical Eye & Vision Group, LTD.

  • Optometrist
  • Bethesda, MD
National Provider Identifier
1164582441
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1193 Issued in MD
Legal business name
KOMM MEDICAL EYE & VISION GROUP, LTD.
Practice address
111 N Brook LN
Bethesda, MD 20814-2610
Phone
(301) 654-7180
NPI assigned
Dec 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gregory Theodore Komm, O.D.NPI 1083774368
Title
President
Phone
(301) 654-7180

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120130000570 DC Part B Supplier - Clinic/Group Practice 3375700644 Receives reassigned benefits from 1 practitioner
Practice locations: Bethesda, MD; Gaithersburg, MD; Hyattsville, MD; Potomac, MD

National Provider Directory

National Provider Directory

Locations

41238 Margarita Rd
Ste 105
Temecula, CA 92591
Phone (951) 587-2333

4942 Saint Elmo Ave
#T
Bethesda, MD 20814
Phone (301) 657-3332

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

2970 Belcrest Center Dr
Ste 109C
Hyattsville, MD 20782
Phone (301) 799-8600

10130 River Rd
Unit A
Potomac, MD 20854
Phone (301) 299-5222

1776 E Jefferson St
Rockville, MD 20852
Phone (301) 881-7422

Practitioners & affiliated clinicians

Practitioners 9

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": "1165622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164582441",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOMM MEDICAL EYE & VISION GROUP, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOMM",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "THEODORE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-654-7180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.