Organization Active NPI

Samuel F. Boles MD PC

Doing business as Anne Arundel Eye Center

  • Optometrist
  • Annapolis, MD
National Provider Identifier
1164790531
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SAMUEL F. BOLES MD PC
Doing business as
Anne Arundel Eye Center
Practice address
127 Lubrano Dr
Suite 301
Annapolis, MD 21401-7114
Phone
(410) 224-2010
Fax
(410) 224-3044
NPI assigned
Dec 13, 2011
Last updated
Nov 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Authorized official

Name
Samuel F Boles, MDNPI 1255338307
Title
Physician/Owner
Phone
(410) 224-2010

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
Optometrist 152W00000X MD Primary

Addresses

Primary practice location

127 Lubrano Dr
Suite 301
Annapolis, MD 21401-7114

Mailing address

PO Box 62084
Baltimore, MD 21264-2084
Phone (443) 481-6524

Other identifiers 1

IdentifierTypeStateIssuer
226611300MedicaidMD

Other names 1

  • Anne Arundel Eye Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Anne Arundel Eye Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351728000000",
    "number": "1164790531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62084",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212642084",
            "telephone_number": "443-481-6524",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 LUBRANO DR",
            "address_2": "SUITE 301",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017114",
            "telephone_number": "410-224-2010",
            "fax_number": "410-224-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL F. BOLES MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2012-11-01",
        "status": "A",
        "authorized_official_last_name": "BOLES",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "410-224-2010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226611300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anne Arundel Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; 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.