NPIMap

Individual provider Active NPI

Edward J Schwartzberg, O.D.

  • Optometrist
  • Waldorf, MD
National Provider Identifier
1215969035
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA0624 Issued in MD
Practice address
2955 Crain Highway
Suite a&B
Waldorf, MD 20601
Phone
(301) 843-1000
Fax
(301) 843-1919
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA0624 MD Primary
Optometrist 152W00000X 0618001126 VA
Optometrist 152W00000X OP726 DC

Addresses

Primary practice location

2955 Crain Highway
Suite a&B
Waldorf, MD 20601

Mailing address

2955 Crain Highway
Suite a&B
Waldorf, MD 20601
Phone (301) 843-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OP726DCMDOptometrist
0618001126VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ballston Optometry, LLC Optometrist Past Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1215969035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 CRAIN HIGHWAY",
            "address_2": "SUITE A&B",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "20601",
            "telephone_number": "301-843-1000",
            "fax_number": "301-843-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 CRAIN HIGHWAY",
            "address_2": "SUITE A&B",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "20601",
            "telephone_number": "301-843-1000",
            "fax_number": "301-843-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZBERG",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA0624",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001126",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DC",
            "license": "OP726",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.