Individual provider Active NPI

Stanley Allen Feinblum, O.D.

  • Optometrist
  • Easton, MD
National Provider Identifier
1205814795
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA0663 Issued in MD
Practice address
210 Marlboro Ave
Suite 31
Easton, MD 21601-2765
Phone
(410) 822-3937
Fax
(410) 822-2652
NPI assigned
Jan 4, 2006
Last updated
Nov 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA0663 MD Primary

Addresses

Primary practice location

210 Marlboro Ave
Suite 31
Easton, MD 21601-2765

Mailing address

210 Marlboro Ave
Suite 31
Easton, MD 21601-2765
Phone (410) 822-3937

Other identifiers 1

IdentifierTypeStateIssuer
418419000MedicaidMD

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
I20110601000819 MD Practitioner - Optometry 7214920511 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince May 2, 2022 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince May 2, 2022 Accepting new patients

Locations

401 Race St
Cambridge, MD 21613
Phone (401) 228-0500

210 Marlboro Ave
Ste 31
Easton, MD 21601
Phone (410) 822-3937

28522 Marlboro Ave
#A
Easton, MD 21601
Phone (410) 690-8844

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

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1205814795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 MARLBORO AVE",
            "address_2": "SUITE 31",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216012765",
            "telephone_number": "410-822-3937",
            "fax_number": "410-822-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MARLBORO AVE",
            "address_2": "SUITE 31",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216012765",
            "telephone_number": "410-822-3937",
            "fax_number": "410-822-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEINBLUM",
        "first_name": "STANLEY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA0663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "418419000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

Verify at the official NPI Registry.