NPIMap

Organization Active NPI

Jarrettsville Family Eyecare LLC

  • Eyewear Supplier
  • Jarrettsville, MD
National Provider Identifier
1497089627
Registry record updated Oct 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
TA0769 Issued in MD
Legal business name
JARRETTSVILLE FAMILY EYECARE LLC
Practice address
3718 Norrisville Rd
Ste. a
Jarrettsville, MD 21084-1419
Phone
(410) 557-8800
Fax
(410) 557-2811
NPI assigned
Sep 21, 2009
Last updated
Oct 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2009

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

Authorized official

Name
Dr. Jerold M Wassel, O.D.NPI 1679636310
Title
Owner
Phone
(410) 557-8800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X TA0769 MD Primary

Addresses

Primary practice location

3718 Norrisville Rd
Ste. a
Jarrettsville, MD 21084-1419

Mailing address

3718 Norrisville Rd
Ste. a
Jarrettsville, MD 21084-1419
Phone (410) 557-8800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230726001046 MD Part B Supplier - Clinic/Group Practice 3678690419 Receives reassigned benefits from 1 practitioner
Practice locations: Jarrettsville, MD

National Provider Directory

National Provider Directory

Locations

3718 Norrisville Rd
#A
Jarrettsville, MD 21084
Phone (410) 557-8800

Practitioners & affiliated clinicians

Practitioners 2

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": "1253491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1497089627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3718 NORRISVILLE RD",
            "address_2": "STE. A",
            "city": "JARRETTSVILLE",
            "state": "MD",
            "postal_code": "210841419",
            "telephone_number": "410-557-8800",
            "fax_number": "410-557-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3718 NORRISVILLE RD",
            "address_2": "STE. A",
            "city": "JARRETTSVILLE",
            "state": "MD",
            "postal_code": "210841419",
            "telephone_number": "410-557-8800",
            "fax_number": "410-557-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JARRETTSVILLE FAMILY EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-21",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "WASSEL",
        "authorized_official_first_name": "JEROLD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-557-8800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MD",
            "license": "TA0769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jarrettsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; 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.