Individual provider Active NPI

Andrew Joseph Doyle, OD

  • Optometrist
  • Crofton, MD
National Provider Identifier
1184685752
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1726 Issued in MD
Practice address
1702 Transportation Blvd.
Ste I
Crofton, MD 21114
Phone
(410) 721-2500
Fax
(410) 721-1308
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 12264T CA
Optometrist 152W00000X TA1726 MD Primary

Addresses

Primary practice location

1702 Transportation Blvd.
Ste I
Crofton, MD 21114

Mailing address

1702 Transportation Blvd.
Ste I
Crofton, MD 21114
Phone (410) 721-2500

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
I20181121000100 MD Practitioner - Optometry 6103170527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crofton Family Eye Care LLCGroup PAC ID 9335332824, 3 clinicians

Practice addresses (Care Compare)

1702 Transportation Blvd
Suite I
Crofton, MD 21114-2149
Phone (410) 721-2500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12264TCAMDOptometrist
TA1726MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Crofton Family Eye Care LLC Optometrist CurrentSince Dec 17, 2018 Accepting new patients

Locations

1702 Transportation Blvd
Ste I
Crofton, MD 21114
Phone (410) 721-2500

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1184685752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 TRANSPORTATION BLVD.",
            "address_2": "STE I",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "21114",
            "telephone_number": "410-721-2500",
            "fax_number": "410-721-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 TRANSPORTATION BLVD.",
            "address_2": "STE I",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "21114",
            "telephone_number": "410-721-2500",
            "fax_number": "410-721-1308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12264T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

Verify at the official NPI Registry.