Anum Ali
Individual provider Active NPI Optometrist · Gaithersburg, MD
NPI 1356724769 · NPPES record last updated Jul 2, 2015
Key facts
- NPI
- 1356724769
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- DA2473 (MD)
- Practice address
- 80 Market St
Gaithersburg, MD 20878-6532 - Phone
- (301) 990-1122
- Fax
- (301) 990-1142
- NPI assigned
- Jul 2, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171003006647 | MD | Practitioner - Optometry | 4082920186 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DA2473 | MD | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My Eye Dr. Optometrists, LLC | Optometrist | Past | Accepting new patients |
| Visionworks Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | DA2473 | MD | Yes |
Addresses
Primary practice location
80 Market St
Gaithersburg, MD 20878-6532
Mailing address
1950 Old Gallows Rd
520
Vienna, VA 22182-3990
Phone (703) 847-8899
Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.