Individual provider Active NPI

Abraham Solomon Zuckerbrod, O.D.

  • Optometrist
  • Baltimore, MD
National Provider Identifier
1205106648
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2257 Issued in MD
Practice address
1860B Reisterstown Rd
Baltimore, MD 21208-1335
Phone
(410) 864-2526
Fax
(410) 230-1221
NPI assigned
Jan 2, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X TA2257 MD
Optometrist 152W00000X TA2257 MD Primary

Addresses

Primary practice location

1860B Reisterstown Rd
Baltimore, MD 21208-1335

Mailing address

1860B Reisterstown Rd
Baltimore, MD 21208-1335
Phone (410) 864-2526

Other identifiers 2

IdentifierTypeStateIssuer
TA2257OtherMDMD OPTOMETRY LICENSE
777335800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220922002111 MD Practitioner - Optometry 8224413596 Reassigns benefits to 2 organizations
I20220922002349 DC Practitioner - Optometry 8224413596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1860 Reisterstown Rd
Suite B
Baltimore, MD 21208-1335
Phone (410) 428-4182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Oct 23, 2022 Accepting new patients
Personaleyes LLC Optometrist CurrentSince Jun 1, 2023 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Oct 23, 2022 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Rockville Optometry, LLC Optometrist CurrentSince Oct 23, 2022 Accepting new patients
Ronald B Montano DDS PC Past Accepting new patients
Michael G Pharris OD PC Optometrist Past Accepting new patients

Locations

1860 Reisterstown Rd
#B
Baltimore, MD 21208
Phone (410) 428-4182

6306 York Rd
#1-2
Baltimore, MD 21212
Phone (443) 863-5206

1860B Reisterstown Rd
Baltimore, MD 21208
Phone (410) 864-2526

6455 Dobbin Rd
Ste 47
Columbia, MD 21045
Phone (443) 542-5999

14700 Baltimore Ave
Unit 109
Laurel, MD 20707
Phone (301) 245-3903

1860 Reisterstown Rd
Pikesville, MD 21208
Phone (410) 415-5105

14929 Shady Grove Rd
Unit K
Rockville, MD 20850
Phone (301) 424-1050

8529 Georgia Ave
Silver Spring, MD 20910
Phone (301) 588-3232

2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 7

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": "1325462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1205106648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860B REISTERSTOWN RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212081335",
            "telephone_number": "410-864-2526",
            "fax_number": "410-230-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860B REISTERSTOWN RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212081335",
            "telephone_number": "410-864-2526",
            "fax_number": "410-230-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUCKERBROD",
        "first_name": "ABRAHAM",
        "middle_name": "SOLOMON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-02",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MD",
            "license": "TA2257",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD OPTOMETRY LICENSE",
            "identifier": "TA2257",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "777335800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.