Individual provider Active NPI

Dominic Letray Brown, OD

  • Optometrist
  • Bel Air, MD
National Provider Identifier
1205454055
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2789 Issued in MD
Practice address
5 Bel Air South Pkwy Ste 1317
Bel Air, MD 21015-3801
Phone
(410) 569-8113
Fax
(410) 569-8585
NPI assigned
Jul 8, 2020
Last updated
Apr 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003676 PA
Optometrist 152W00000X TA2789 MD Primary

Addresses

Primary practice location

5 Bel Air South Pkwy Ste 1317
Bel Air, MD 21015-3801

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

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
I20210607002020 MD Practitioner - Optometry 0446675607 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

10751 Falls Rd
Lutherville, MD 21093-4517
Phone (410) 955-3663

1800 Orleans St
Baltimore, MD 21287-0010
Phone (410) 955-5000

4692 Millennium Dr
Suite 200
Belcamp, MD 21017-1544
Phone (410) 836-7010

600 N Wolf St
Baltimore, MD 21287-0005
Phone (410) 955-5000

600 N Wolfe St
Blalock 266
Baltimore, MD 21287-0005
Phone (410) 502-4340

6201 Greenleigh Ave
Middle River, MD 21220-2004

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA2789MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Jul 1, 2021 Accepting new patients
Johns Hopkins University Optometrist CurrentSince Jul 1, 2021 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Apr 25, 2022 Accepting new patients
Johns Hopkins University Current Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Apr 25, 2022 Accepting new patients

Locations

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

5 Bel Air South Pkwy
Ste 1317
Bel Air, MD 21015
Phone (410) 569-8113

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

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

10751 Falls Rd
Timonium, MD 21093
Phone (410) 583-2727

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

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: dbrown848728@direct.hopkinsmedicine.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1205454055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BEL AIR SOUTH PKWY STE 1317",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210153801",
            "telephone_number": "410-569-8113",
            "fax_number": "410-569-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DOMINIC",
        "middle_name": "LETRAY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-08",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003676",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.