NPIMap

Organization Active NPI

Dr. Alexander C Nnabue and Associates PA

Doing business as Visual Eyes

  • Corneal and Contact Management Optometrist
  • Clinton, MD
National Provider Identifier
1245479336
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
TA1277 Issued in MD
Legal business name
DR. ALEXANDER C NNABUE AND ASSOCIATES PA
Doing business as
Visual Eyes
Practice address
8931 Woodyard Rd
Clinton, MD 20735-4203
Phone
(301) 877-1770
Fax
(301) 877-3207
NPI assigned
Feb 12, 2009
Last updated
Dec 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Authorized official

Name
Dr. Patricia Parks
Title
Billing Manager
Phone
(517) 231-4086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X TA1277 MD Primary

Addresses

Primary practice location

8931 Woodyard Rd
Clinton, MD 20735-4203

Mailing address

10240 Lake Arbor Way
Mitchellville, MD 20721-3113
Phone (301) 324-9500

Other identifiers 2

IdentifierTypeStateIssuer
6907415MedicaidMD
26458100MedicaidDC

Other names 1

  • VISUAL EYES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131113000091 DC Part B Supplier - Clinic/Group Practice 1355577743 Receives reassigned benefits from 5 practitioners
Practice locations: Clinton, MD; Greenbelt, MD; Hyattsville, MD; Mitchellville, MD; Silver Spring, MD
O20150109001233 MD Part B Supplier - Clinic/Group Practice 1355577743 Receives reassigned benefits from 3 practitioners
Practice locations: Frederick, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2056652Visual Eyes8931 Woodyard Road, Clinton, MD 20735Certificate of waiverApr 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
Dr Alexander C Nnabue and Associates PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

8931 Woodyard Rd
Clinton, MD 20735
Phone (301) 877-1770

1835 University Blvd E
Ste 228
Hyattsville, MD 20783
Phone (301) 434-3937

10313 Georgia Ave
Ste 109
Silver Spring, MD 20902
Phone (301) 681-9797

48 Watkins Park Dr
Upper Marlboro, MD 20774
Phone (301) 249-5890

Practitioners & affiliated clinicians

Practitioners 9

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": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1245479336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10240 LAKE ARBOR WAY",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207213113",
            "telephone_number": "301-324-9500",
            "fax_number": "301-324-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8931 WOODYARD RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354203",
            "telephone_number": "301-877-1770",
            "fax_number": "301-877-3207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ALEXANDER C NNABUE AND ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "517-231-4086",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MD",
            "license": "TA1277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6907415",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26458100",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VISUAL EYES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.