Individual provider Active NPI

Morgan Rudeau, OD

  • Optometrist
  • Mount Airy, MD
National Provider Identifier
1437895745
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2848 Issued in MD
Practice address
1507 S Main St
Mount Airy, MD 21771-5393
Phone
(301) 829-2221
NPI assigned
May 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 2848 MD Primary

Addresses

Primary practice location

1507 S Main St
Mount Airy, MD 21771-5393

Mailing address

1507 S Main St
Mount Airy, MD 21771-5393

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
I20220816003342 MD Practitioner - Optometry 2466835970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mt. Airy Eye Care, LLCGroup PAC ID 4880644301, 4 clinicians

Practice addresses (Care Compare)

1507 S Main St
Mount Airy, MD 21771-5393
Phone (301) 829-2221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2848MDMDOptometrist

Organizations & group practices 1

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": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1437895745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 S MAIN ST",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217715393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 S MAIN ST",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217715393",
            "telephone_number": "301-829-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDEAU",
        "first_name": "MORGAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-10",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "2848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, MD

Sources for this page

Verify at the official NPI Registry.