Individual provider Active NPI

Dawn Gill, OD

  • Optometrist
  • Frederick, MD
National Provider Identifier
1417986233
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1338 Issued in MD
Practice address
7420 Hayward Rd Ste 202
Frederick, MD 21702-2509
Phone
(301) 662-8866
Fax
(301) 662-8890
NPI assigned
Jul 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1338 MD Primary

Addresses

Primary practice location

7420 Hayward Rd Ste 202
Frederick, MD 21702-2509

Mailing address

7420 Hayward Rd
Ste 202
Frederick, MD 21702-2509
Phone (301) 662-8866

Other identifiers 12

IdentifierTypeStateIssuer
60645801OtherCAREFIRST BCBS
60645901OtherBLUE CROSS BLUE SHIELD
1078176OtherAETNA-HMO
271520OtherMAMSI/UNITED HEALTHCARE
620428OtherHEALTHLINK/NCPPO
620428OtherUNICARE
271520OtherONENET
0002OtherBCBS FEP
271520OtherMDIPA
271520OtherALLIANCE
5041476OtherAETNA
271520OtherOPTIMUM CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20101109000075 MD Practitioner - Optometry 6305959925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Longmeadow Optical, LTDGroup PAC ID 1951420298, 2 clinicians

Practice addresses (Care Compare)

7420 Hayward Rd
Suite 202
Frederick, MD 21702-2509
Phone (301) 662-8866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Longmeadow Optical Optometrist CurrentSince Sep 1, 2000 Accepting new patients
Longmeadow Optical, LTD Optometrist CurrentSince Aug 2, 1999 Accepting new patients
Jay C Grochmal, M.D., P.a. PastSince Aug 1, 1996 Accepting new patients

Locations

7420 Hayward Rd
Ste 202
Frederick, MD 21702
Phone (301) 662-8866

1560 Opossumtown Pike
Frederick, MD 21702
Phone (301) 662-8866

Interoperability endpoints

  • Direct secure messaging: dawng@longmeadowoptical.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1417986233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7420 HAYWARD RD",
            "address_2": "STE 202",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217022509",
            "telephone_number": "301-662-8866",
            "fax_number": "301-662-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7420 HAYWARD RD STE 202",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217022509",
            "telephone_number": "301-662-8866",
            "fax_number": "301-662-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "60645801",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "60645901",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA-HMO",
            "identifier": "1078176",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI/UNITED HEALTHCARE",
            "identifier": "271520",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK/NCPPO",
            "identifier": "620428",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "620428",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONENET",
            "identifier": "271520",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FEP",
            "identifier": "0002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA",
            "identifier": "271520",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE",
            "identifier": "271520",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5041476",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM CHOICE",
            "identifier": "271520",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.