Organization Active NPI

Baltimore Ophthalmology, LLC

  • Ophthalmology Physician
  • Baltimore, MD
National Provider Identifier
1528569233
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
BALTIMORE OPHTHALMOLOGY, LLC
Practice address
6418 Reisterstown Rd
Baltimore, MD 21215-2308
Phone
(410) 318-8855
Fax
(410) 764-3229
NPI assigned
Feb 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Authorized official

Name
Ryan Hahn
Title
Medical Director
Phone
(410) 764-9360

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

6418 Reisterstown Rd
Baltimore, MD 21215-2308

Mailing address

6418 Reisterstown Rd
Baltimore, MD 21215-2308
Phone (410) 318-8855

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180507000620 MD Part B Supplier - Clinic/Group Practice 6204190846 Receives reassigned benefits from 2 practitioners
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Locations

6418 Reisterstown Rd
Baltimore, MD 21215
Phone (410) 318-8855

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519689600000",
    "number": "1528569233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6418 REISTERSTOWN RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212152308",
            "telephone_number": "410-318-8855",
            "fax_number": "410-764-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6418 REISTERSTOWN RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212152308",
            "telephone_number": "410-318-8855",
            "fax_number": "410-764-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALTIMORE OPHTHALMOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-02-27",
        "status": "A",
        "authorized_official_last_name": "HAHN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "410-764-9360"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; 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.