Individual provider Active NPI

Susan Chiu Brule, O.D.

  • Optometrist
  • Olney, MD
National Provider Identifier
1386770188
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1496 Issued in MD
Practice address
3423 Olney Laytonsville Rd Ste 2
Olney, MD 20832-3708
Phone
(301) 774-2434
Fax
(301) 774-0312
NPI assigned
Feb 26, 2007
Last updated
Jan 26, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1496 MD Primary

Addresses

Primary practice location

3423 Olney Laytonsville Rd Ste 2
Olney, MD 20832-3708

Mailing address

3423 Olney Laytonsville Rd Ste 2
Olney, MD 20832-3708
Phone (301) 774-2434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191029001412 DC Practitioner - Optometry 8820320658 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1496MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Village Eye Center Inc Optometrist CurrentSince Sep 7, 2019 Accepting new patients
Aeg Maryland Professional LLC Optometrist CurrentSince Jul 23, 2023 Accepting new patients
Olney Opticians,Inc. Past Accepting new patients

Locations

18310 Montgomery Village Ave
Ste 140
Gaithersburg, MD 20879
Phone (301) 698-4070

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1386770188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3423 OLNEY LAYTONSVILLE RD STE 2",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208323708",
            "telephone_number": "301-774-2434",
            "fax_number": "301-774-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3423 OLNEY LAYTONSVILLE RD STE 2",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208323708",
            "telephone_number": "301-774-2434",
            "fax_number": "301-774-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRULE",
        "first_name": "SUSAN",
        "middle_name": "CHIU",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "1496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.