Individual provider Active NPI

Jerry Durnan, O.D.

  • Optometrist
  • Elkton, MD
National Provider Identifier
1427212414
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2100 Issued in MD
Practice address
360 E Pulaski Hwy Ste 1B
Elkton, MD 21921-6592
Phone
(410) 398-5240
Fax
(410) 398-4762
NPI assigned
Jul 18, 2008
Last updated
Apr 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2100 MD Primary

Addresses

Primary practice location

360 E Pulaski Hwy Ste 1B
Elkton, MD 21921-6592

Mailing address

920 Revolution St
Havre de Grace, MD 21078-3748
Phone (410) 939-2200

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
I20160804000367 MD Order and Referring Only - OptometryPractitioner - Optometry 0749340404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shyu Eye Care LLC PastSince Jul 23, 2026 Accepting new patients
Middletown Eye Care PA Optometrist PastSince May 3, 2020 Accepting new patients

Organizations & group practices 2

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": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1427212414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783748",
            "telephone_number": "410-939-2200",
            "fax_number": "410-939-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E PULASKI HWY STE 1B",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216592",
            "telephone_number": "410-398-5240",
            "fax_number": "410-398-4762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURNAN",
        "first_name": "JERRY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-18",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

Verify at the official NPI Registry.