Organization Active NPI

Columbia Eye Associates, LLC

  • Optometrist
  • Columbia, MD
National Provider Identifier
1467151696
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
COLUMBIA EYE ASSOCIATES, LLC
Practice address
10015 Old Columbia Rd Ste J135
Columbia, MD 21046-1741
Phone
(410) 381-1688
Fax
(410) 381-3855
NPI assigned
Feb 27, 2023
Last updated
Feb 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Authorized official

Name
Christopher A Coleman, O.D.NPI 1447219282
Title
Owner/Optometrist
Phone
(240) 498-6768

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

10015 Old Columbia Rd Ste J135
Columbia, MD 21046-1741

Mailing address

10015 Old Columbia Rd Ste J135
Columbia, MD 21046-1741
Phone (410) 381-1688

Other identifiers 2

IdentifierTypeStateIssuer
41817OtherMDDAVIS VISION
Y673-0002OtherMDBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230412001500 MD Part B Supplier - Clinic/Group Practice 1052786696 Receives reassigned benefits from 3 practitioners
Practice locations: Columbia, MD

National Provider Directory

National Provider Directory

Locations

10015 Old Columbia Rd
Ste J135
Columbia, MD 21046
Phone (301) 370-0254

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1467151696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10015 OLD COLUMBIA RD STE J135",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461741",
            "telephone_number": "410-381-1688",
            "fax_number": "410-381-3855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10015 OLD COLUMBIA RD STE J135",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461741",
            "telephone_number": "410-381-1688",
            "fax_number": "410-381-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA EYE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "240-498-6768",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "41817",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y673-0002",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.