Eye Care and Surgical Center of Laurel PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

D52388 Issued in MD

Legal business name

EYE CARE AND SURGICAL CENTER OF LAUREL PC

Practice address

615 Main St
Laurel, MD 20707-4065

Phone

(301) 725-3010

Fax

(301) 725-3271

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

John P Grundy III, MDNPI 1194775932

Title

Owner

Phone

(301) 725-3010

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Enrollment records 2

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Snowden River Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Ellicott City, MD
  • NPI 1447258603

  Member Of

  NPD member

Locations

Practitioners 3

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

• John Patrick Grundy III, M.D.

  • Ophthalmology Physician
  • Laurel, MD
  • NPI 1194775932

  DC

  Medicare reassignment NPD Authorized official
• Andre Cherisca Jr.

  • Optician
  • Laurel, MD
  • NPI 1982833059
  NPD (past)
• Bernard Ehrlich, MD

  • Ophthalmology Physician
  • Laurel, MD
  • NPI 1891731600
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393200000000",
    "number": "1386756161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 MAIN ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074065",
            "telephone_number": "301-725-3010",
            "fax_number": "301-725-3271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 MAIN ST",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074065",
            "telephone_number": "301-725-3010",
            "fax_number": "301-725-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE AND SURGICAL CENTER OF LAUREL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-02-24",
        "status": "A",
        "authorized_official_last_name": "GRUNDY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-725-3010",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D52388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "236605300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elliott N Exar, M.D.
• Excite Dental of Laurel
• Eye Can See Optical
• Eye Can See Optical
• Eye Care and Surgery PA
• Temietan A Eyenuro
• Lawrence Eyong-Echaw
• Joseph Eyong, HHA
• Oluwafunke Fadairo
• Agnes Fadika

• Specialist in Laurel, MD
• Providers in Laurel, MD by specialty
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.