NPIMap

Organization Active NPI

Urbana Eye Care LLC

  • Optometrist
  • Frederick, MD
National Provider Identifier
1184953788
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1469 Issued in MD
Legal business name
URBANA EYE CARE LLC
Practice address
8925 Fingerboard Rd
Suite E
Frederick, MD 21704-8163
Phone
(301) 810-5104
Fax
(301) 810-5105
NPI assigned
Dec 10, 2009
Last updated
Dec 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Authorized official

Name
Dr. Irving Gan, O.D.NPI 1679792683
Title
President
Phone
(301) 810-5104

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 TA1469 MD Primary

Addresses

Primary practice location

8925 Fingerboard Rd
Suite E
Frederick, MD 21704-8163

Mailing address

8925 Fingerboard Rd
Suite E
Frederick, MD 21704-8163
Phone (301) 810-5104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091229000525 MD Part B Supplier - Clinic/Group Practice 0749320588 Receives reassigned benefits from 2 practitioners
Practice locations: Frederick, MD

National Provider Directory

National Provider Directory

Locations

8925 Fingerboard Rd
Ste E
Frederick, MD 21704
Phone (301) 810-5104

Practitioners & affiliated clinicians

Practitioners 2

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": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260403200000",
    "number": "1184953788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8925 FINGERBOARD RD",
            "address_2": "SUITE E",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048163",
            "telephone_number": "301-810-5104",
            "fax_number": "301-810-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8925 FINGERBOARD RD",
            "address_2": "SUITE E",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048163",
            "telephone_number": "301-810-5104",
            "fax_number": "301-810-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URBANA EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2009-12-10",
        "status": "A",
        "authorized_official_last_name": "GAN",
        "authorized_official_first_name": "IRVING",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-810-5104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.