Individual provider Active NPI

George Constantinopoulos, O.D.

  • Optometrist
  • Hanover, MD
National Provider Identifier
1376689794
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1802 Issued in MD
Practice address
7077 Arundel Mills Cir
Hanover, MD 21076-1387
Phone
(410) 379-3101
Fax
(410) 379-3125
NPI assigned
Jan 30, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1802 MD Primary

Addresses

Primary practice location

7077 Arundel Mills Cir
Hanover, MD 21076-1387

Mailing address

1144 August Dr
Annapolis, MD 21403-4613
Phone (443) 482-3816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, IL2 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
I20210503002783 NY Practitioner - Optometry 4284043266 Reassigns benefits to 1 organization
I20220208000857 IL Practitioner - Optometry 4284043266 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA1802MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Vision Center, Inc CurrentSince Mar 1, 2021 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Mar 1, 2021 Accepting new patients
Austin-Cleetus LTD Optometrist CurrentSince Feb 1, 2022 Accepting new patients

Locations

17W685 Roosevelt Rd
Oakbrook Terrace, IL 60181
Phone (630) 916-8282

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

8511 126th St
Kew Gardens, NY 11415
Phone (718) 849-7773

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

175 E Houston St
San Antonio, TX 78205
Phone (210) 524-6982

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376689794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 AUGUST DR",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214034613",
            "telephone_number": "443-482-3816",
            "fax_number": "410-379-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7077 ARUNDEL MILLS CIR",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761387",
            "telephone_number": "410-379-3101",
            "fax_number": "410-379-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANTINOPOULOS",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, MD

Sources for this page

Verify at the official NPI Registry.