NPIMap

Organization Active NPI

Mid Atlantic Eye, LLC

  • Ophthalmology Physician
  • Towson, MD
National Provider Identifier
1346488343
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D0067362 Issued in MD
Legal business name
MID ATLANTIC EYE, LLC
Doing business as
Mid Atlantic Eye Consultants
Mid-Atlantic Cornea Consultants
Practice address
40 York Rd Ste 500
Towson, MD 21204-5243
Phone
(410) 616-9952
Fax
(443) 927-7515
NPI assigned
Jan 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Authorized official

Name
Dr. Sudeep Pramanik, MD, MBANPI 1225020159
Title
President
Phone
(410) 616-9952

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X D0067362 MD Primary
Ophthalmologic Surgery Clinic/Center 261QS0132X

Addresses

Primary practice location

40 York Rd Ste 500
Towson, MD 21204-5243

Mailing address

40 York Rd Ste 500
Towson, MD 21204-5243
Phone (410) 616-9952

Other identifiers 2

IdentifierTypeStateIssuer
025039200MedicaidMD
1016496560002MedicaidPA

Other names 2

  • Mid Atlantic Eye Consultants Doing business as
  • Mid-Atlantic Cornea Consultants Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110225000564 PA Part B Supplier - Clinic/Group Practice 1153502976 Receives reassigned benefits from 7 practitioners
Practice locations: York, PA
O20110225000658 MD Part B Supplier - Clinic/Group Practice 1153502976 Receives reassigned benefits from 6 practitioners
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Locations

6569 N Charles St
Ste 5
Baltimore, MD 21204

40 York Rd
Ste 500
Towson, MD 21204
Phone (410) 616-9952

1750 5th Ave
Ste 301
York, PA 17403
Phone (717) 843-7829

Interoperability endpoints

  • Direct secure messaging: csherrin@macc.intellechartdirect.net
  • Direct secure messaging: spramanik@macc.intellechartdirect.net
  • Direct secure messaging: sbell@macc.intellechartdirect.net
  • Direct secure messaging: mtseng@macc.intellechartdirect.net
  • Direct secure messaging: cluzuriaga@macc.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700524800000",
    "number": "1346488343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 YORK RD STE 500",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212045243",
            "telephone_number": "410-616-9952",
            "fax_number": "443-927-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 YORK RD STE 500",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212045243",
            "telephone_number": "410-616-9952",
            "fax_number": "443-927-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID ATLANTIC EYE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-29",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A",
        "authorized_official_last_name": "PRAMANIK",
        "authorized_official_first_name": "SUDEEP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-616-9952",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MBA"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0067362",
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025039200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016496560002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid Atlantic Eye Consultants",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mid Atlantic Eye Consultants",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mid-Atlantic Cornea Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.