Individual provider Active NPI

William D O'Donnell, M.D.

  • Ophthalmology Physician
  • Silver Spring, MD
National Provider Identifier
1215952437
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D0004530 Issued in MD
Practice address
2101 Medical Park Dr
Silver Spring, MD 20902-4053
Phone
(301) 681-6600
Fax
(301) 681-3799
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D0004530 MD Primary

Addresses

Primary practice location

2101 Medical Park Dr
Silver Spring, MD 20902-4053

Mailing address

12117 Red Admiral Way
Germantown, MD 20876-5939
Phone (301) 916-6160

Other identifiers 3

IdentifierTypeStateIssuer
255018OtherUNITED HEALTHCARE - MAMSI
0003OtherBLUE CROSS/BLUE SHIELD
180030694OtherMEDICARE - RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100423000051 DC Practitioner - Ophthalmology 8123155132 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0004530MDMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ladas Eye Group PA Ophthalmology CurrentSince Oct 1, 1981 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2101 Medical Park Dr
Silver Spring, MD 20902
Phone (301) 681-6600

2101 Medical Park Dr
Ste 101
Silver Spring, MD 20902
Phone (301) 681-6600

Organizations & group practices 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215952437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12117 RED ADMIRAL WAY",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208765939",
            "telephone_number": "301-916-6160",
            "fax_number": "301-916-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 MEDICAL PARK DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209024053",
            "telephone_number": "301-681-6600",
            "fax_number": "301-681-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "WILLIAM",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0004530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE - MAMSI",
            "identifier": "255018",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - RAILROAD",
            "identifier": "180030694",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.