Organization Active NPI

Envue Eye & Laser Center LLC

  • Ophthalmology Physician
  • Oxon Hill, MD
National Provider Identifier
1568086304
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
ENVUE EYE & LASER CENTER LLC
Practice address
120 Waterfront St Ste 300
Oxon Hill, MD 20745-1142
Phone
(301) 485-9533
NPI assigned
Jun 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Authorized official

Name
Dr. Bruce Anthony Rivers, MDNPI 1598893596
Title
Owner
Phone
(301) 485-9533

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 1

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

Addresses

Primary practice location

120 Waterfront St Ste 300
Oxon Hill, MD 20745-1142

Mailing address

120 Waterfront St Ste 300
Oxon Hill, MD 20745-1142
Phone (301) 485-9533

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201110000352 DC Part B Supplier - Clinic/Group Practice 6103236724 Receives reassigned benefits from 1 practitioner
Practice locations: Oxon Hill, MD

National Provider Directory

National Provider Directory

Locations

120 Waterfront St
Ste 300
Oxon Hill, MD 20745
Phone (301) 485-9533

Practitioners & affiliated clinicians

Practitioners 1

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": "1591401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1568086304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WATERFRONT ST STE 300",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207451142",
            "telephone_number": "301-485-9533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WATERFRONT ST STE 300",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207451142",
            "telephone_number": "301-485-9533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVUE EYE & LASER CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-06",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "RIVERS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-485-9533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxon Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.