Individual provider Active NPI

Caroline Sullivan, OD

  • Optometrist
  • Annapolis, MD
National Provider Identifier
1336717768
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2815 Issued in MD
Practice address
1905 Towne Centre Blvd Ste 110
Annapolis, MD 21401-3594
Phone
(410) 268-8200
NPI assigned
Jun 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X TA2815 MD Primary

Addresses

Primary practice location

1905 Towne Centre Blvd Ste 110
Annapolis, MD 21401-3594

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other names 1

  • Caroline Krupa Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210707001540 MD Practitioner - Optometry 2668874116 Reassigns benefits to 1 organization
I20210714000139 DC Practitioner - Optometry 2668874116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Maryland LLCGroup PAC ID 6002037629, 121 clinicians

Practice addresses (Care Compare)

2321 Forest Dr
Suite E
Annapolis, MD 21401-4679
Phone (410) 266-3369

4412 Mitchellville Rd
Bowie, MD 20716-3112
Phone (301) 809-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Aug 1, 2021 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Aug 1, 2021 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Aug 1, 2021 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients

Locations

2321 Forest Dr
Annapolis, MD 21401
Phone (410) 266-3369

1905 Towne Centre Blvd
Ste 110
Annapolis, MD 21401
Phone (410) 268-8200

6306 York Rd
#1-2
Baltimore, MD 21212
Phone (443) 863-5206

5701 Greenbelt Rd
Ste 520
Berwyn Heights, MD 20740
Phone (301) 345-2053

4412 Mitchellville Rd
Bowie, MD 20716
Phone (301) 309-0000

6804 Race Track Rd
Bowie, MD 20715
Phone (301) 262-1210

6455 Dobbin Rd
Ste 47
Columbia, MD 21045
Phone (443) 542-5999

10264 Southern Md Blvd
Ste 101
Dunkirk, MD 20754
Phone (410) 257-6931

210 Marlboro Ave
Ste 31
Easton, MD 21601
Phone (410) 822-3937

19814 Century Blvd
Germantown, MD 20874
Phone (301) 540-1200

2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 5

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": "1623542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1336717768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 TOWNE CENTRE BLVD STE 110",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013594",
            "telephone_number": "410-268-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CAROLINE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-13",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "KRUPA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.