Eagle Eye Care, P.a.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

TA 0870 Issued in MD

Legal business name

EAGLE EYE CARE, P.A.

Practice address

6350 Stevens Forest Rd
Suite 101
Columbia, MD 21046-3231

Phone

(410) 964-8516

Fax

(410) 740-8626

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Fred Jeffrey Sirotkin, O.D.NPI 1821109596

Title

Owner-Optometrist

Phone

(410) 964-8516

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fred Jeffrey Sirotkin, O.D.

  • Optometrist
  • Columbia, MD
  • NPI 1821109596
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271376000000",
    "number": "1467593582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6350 STEVENS FOREST RD",
            "address_2": "SUITE 101",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463231",
            "telephone_number": "410-964-8516",
            "fax_number": "410-740-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6350 STEVENS FOREST RD",
            "address_2": "SUITE 101",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463231",
            "telephone_number": "410-964-8516",
            "fax_number": "410-740-8626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE EYE CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2010-04-16",
        "status": "A",
        "authorized_official_last_name": "SIROTKIN",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER-OPTOMETRIST",
        "authorized_official_telephone_number": "410-964-8516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MD",
            "license": "TA 0870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gillian Early
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• Ashley Eason, LCSWC
• Eating Disorders Center of Columbia Maryland

• Eyewear Supplier in Columbia, MD
• Providers in Columbia, MD by specialty
• Eyewear Supplier in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; 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.