Supreme Eye Care LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SUPREME EYE CARE LLC

Practice address

10631 Greenbelt Rd Ste 301
Lanham, MD 20706-2282

Phone

(646) 220-9282

NPI assigned

Nov 15, 2021

Organization subpart

No

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

Authorized official

Name

Olufunso IbrahimNPI 1821508334

Title

Owner

Phone

(301) 979-9878

Specialties & licenses 1

Addresses

Other names 1

• Eye Site Doing business as

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olufunso Ibrahim, O.D.

  • Optometrist
  • Lanham, MD
  • NPI 1821508334

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1255097002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10631 GREENBELT RD # 301",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062282",
            "telephone_number": "301-979-9878",
            "fax_number": "301-979-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10631 GREENBELT RD STE 301",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062282",
            "telephone_number": "646-220-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-15",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "OLUFUNSO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-979-9878"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Site",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Sturm
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• Sunrise Community of Maryland, Inc.
• Korpo Supuwood
• Suzanne B Honeyman DDS PC
• Svetlana Malinsky, DPM PC
• Svetlana Malinsky, DPM PC
• Svetlana Malinsky, DPM PC

• Optometrist in Lanham, MD
• Providers in Lanham, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.