Individual provider Active NPI

Andrew David Brown, OD, MD

  • Optometrist
  • Bethesda, MD
National Provider Identifier
1215302104
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD0000003254 Issued in TN
Practice address
8901 Rockville Pike
Bethesda, MD 20889-9098
Phone
(301) 295-4000
NPI assigned
Dec 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X OD0000003254 TN Primary

Addresses

Primary practice location

8901 Rockville Pike
Bethesda, MD 20889-9098

Mailing address

4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098

Other practice location 1

4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098
Phone (870) 634-6294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20180503000286 MO Order and Referring Only - OptometryPractitioner - Optometry 0143584979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2015015578MOMDOptometrist
OD0000003254TNMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1215302104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 ROCKVILLE PIKE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208899098",
            "telephone_number": "301-295-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4430 Missouri Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Leonard Wood",
            "state": "MO",
            "postal_code": "654739098",
            "country_code": "US",
            "telephone_number": "870-634-6294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ANDREW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "OD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-03",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD0000003254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.