DRS. Blum & Bruck, O.D. P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TAO877 Issued in MD

Legal business name

DRS. BLUM & BRUCK, O.D. P.A.

Practice address

2963 Manchester Rd Ste B
Manchester, MD 21102-1853

Phone

(410) 239-6700

NPI assigned

Sep 24, 2007

Last updated

Jun 5, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eliahu Bruck, ODNPI 1992743678

Title

President

Phone

(410) 239-6700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 2

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.

• Eliahu Bruck, O.D.

  • Optometrist
  • Manchester, MD
  • NPI 1992743678
  Medicare reassignment Care Compare group Authorized official
• David Steven Blum, O.D.

  • Optometrist
  • Baltimore, MD
  • NPI 1679520928
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496620800000",
    "number": "1326234337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2963 MANCHESTER RD STE B",
            "city": "MANCHESTER",
            "state": "MD",
            "postal_code": "211021853",
            "telephone_number": "410-239-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2963 MANCHESTER RD STE B",
            "city": "MANCHESTER",
            "state": "MD",
            "postal_code": "211021853",
            "telephone_number": "410-239-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. BLUM & BRUCK, O.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2017-06-05",
        "status": "A",
        "authorized_official_last_name": "BRUCK",
        "authorized_official_first_name": "ELIAHU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-239-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TAO877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carroll Health Group, LLC
• Matthew Stephen Castagnero, PT, DPT
• Katrina Marie Criaris, LMSW
• Kimberly Lois Davis, FNP-C
• Kayla Dolch, BCBA
• Helaina Brown Ebling, MSW, LCSW-C
• Molly Ellison
• Nikolaus Euwer
• Stephen Freeman, MPT, ATC
• Allison Jean Gidusko, MS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2017; 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.