Individual provider Active NPI

Charles McDonald, OD

  • Optometrist
  • Easton, MD
National Provider Identifier
1437236775
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA0823 Issued in MD
Practice address
220 Marlboro Ave
Tred Avon Square
Easton, MD 21601-2729
Phone
(410) 822-8686
Fax
(410) 822-7853
NPI assigned
Nov 1, 2006
Last updated
Feb 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 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 TA0823 MD Primary

Addresses

Primary practice location

220 Marlboro Ave
Tred Avon Square
Easton, MD 21601-2729

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970

Other identifiers 1

IdentifierTypeStateIssuer
556909500MedicaidMD

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
I20100326000642 MD Practitioner - Optometry 5698721074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Maryland LLCGroup PAC ID 6002037629, 121 clinicians

Practice addresses (Care Compare)

28522 Marlboro Ave
Suite a
Easton, MD 21601-2792
Phone (410) 690-8844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1348SCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Wink Vision Optometrist CurrentSince Oct 23, 2019 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Mar 9, 2020 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Mar 9, 2020 Accepting new patients
Accurate Optical Co of Ocean City Inc Optometrist PastSince Aug 15, 2009 Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients
East Coast Optometric, Inc. Optometrist Past Accepting new patients
East Coast Optometric, Inc Optometrist Past Accepting new patients
Accurate Optical Co of Millsboro Inc. Optometrist PastSince Sep 1, 2010 Accepting new patients

Locations

1905 Towne Centre Blvd
Ste 110
Annapolis, MD 21401
Phone (410) 268-8200

2321 Forest Dr
Annapolis, MD 21401
Phone (410) 266-3369

6306 York Rd
#1-2
Baltimore, MD 21212
Phone (443) 863-5206

2711 Ocean Gtwy
Ste B
Cambridge, MD 21613
Phone (410) 228-1110

28522 Marlboro Ave
#A
Easton, MD 21601
Phone (410) 690-8844

2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 9

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1437236775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 MARLBORO AVE",
            "address_2": "TRED AVON SQUARE",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216012729",
            "telephone_number": "410-822-8686",
            "fax_number": "410-822-7853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA0823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "556909500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

Verify at the official NPI Registry.