Individual provider Active NPI

Brittney Carlos, OD

  • Optometrist
  • Odenton, MD
National Provider Identifier
1235659566
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2558 Issued in MD
Practice address
1215 Annapolis Rd
Odenton, MD 21113-1344
Phone
(410) 672-2515
NPI assigned
Jun 27, 2017
Last updated
Oct 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 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 TA2558 MD Primary

Addresses

Primary practice location

1215 Annapolis Rd
Odenton, MD 21113-1344

Mailing address

704 203Rd St
Pasadena, MD 21122-1506
Phone (334) 237-3889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20220111000990 VA Practitioner - Optometry 6507130119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael J. Bermel, O.D., P.C.Group PAC ID 0244492007, 3 clinicians

Practice addresses (Care Compare)

55 A Catoctin Cir NE
Leesburg, VA 20176-3106
Phone (703) 777-3455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA2558MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael J. Bermel, O.D., P.C. Optometrist CurrentSince Dec 1, 2021 Accepting new patients
Daniel Poth, O.D. and Associates, P.C. Optometrist PastSince Dec 1, 2021 Accepting new patients
Daniel W. Pituch, DMD, MD, PC PastSince Jul 1, 2006 Accepting new patients

Locations

10640 Main St
Ste 100
Fairfax, VA 22030
Phone (703) 691-0755

7909 Stonewall Shops Sq
Gainesville, VA 20155

7945 Stonewall Shops Sq
Gainesville, VA 20155

55 Catoctin Cir NE
Ste A
Leesburg, VA 20176
Phone (703) 777-3455

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": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1235659566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 203RD ST",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211221506",
            "telephone_number": "334-237-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 ANNAPOLIS RD",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211131344",
            "telephone_number": "410-672-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOS",
        "first_name": "BRITTNEY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odenton, MD

Sources for this page

Verify at the official NPI Registry.