NPIMap

Organization Active NPI

Penn Optical Co LTD

  • Optometrist
  • Baltimore, MD
National Provider Identifier
1215123401
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PENN OPTICAL CO LTD
Practice address
2401 Liberty Heights Ave # 3730
Baltimore, MD 21215-8019
Phone
(410) 669-8030
Fax
(410) 669-7366
NPI assigned
Sep 20, 2007
Last updated
Sep 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Authorized official

Name
Dr. Richard Fuss, O.D.NPI 1689639528
Title
President
Phone
(410) 488-6800

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary
Corneal and Contact Management Optometrist 152WC0802X NU
Pediatric Optometrist 152WP0200X NU
Sports Vision Optometrist 152WS0006X NU
Occupational Vision Optometrist 152WX0102X NU

Addresses

Primary practice location

2401 Liberty Heights Ave # 3730
Baltimore, MD 21215-8019

Mailing address

5006 Sinclair LN
Baltimore, MD 21206-5936
Phone (410) 488-6800

National Provider Directory

National Provider Directory
Tax ID family
Penn Optical Co LTD8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2401 Liberty Heights Ave
Ste 3730
Baltimore, MD 21215
Phone (410) 669-8030

Practitioners & affiliated clinicians

Practitioners 1

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": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1215123401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5006 SINCLAIR LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065936",
            "telephone_number": "410-488-6800",
            "fax_number": "410-488-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 LIBERTY HEIGHTS AVE # 3730",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212158019",
            "telephone_number": "410-669-8030",
            "fax_number": "410-669-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN OPTICAL CO LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "FUSS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-488-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.