Individual provider Active NPI

Cerina Leigh Buchanan

  • Optometrist
  • Bowie, MD
National Provider Identifier
1588031793
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2482 Issued in MD
Practice address
6804 Race Track Rd
Bowie, MD 20715-3011
Phone
(301) 262-1210
Fax
(301) 352-3568
NPI assigned
Aug 24, 2015
Last updated
Oct 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2452 NC
Optometrist 152W00000X TA2482 MD Primary

Addresses

Primary practice location

6804 Race Track Rd
Bowie, MD 20715-3011

Mailing address

1950 Old Gallows Rd 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

860 Summit Crossing Pl Ste 110
Gastonia, NC 28054-2217
Phone (704) 865-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, NC, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20151228001042 MD Practitioner - Optometry 0648571232 Reassigns benefits to 2 organizations
I20161228000431 NC Practitioner - Optometry 0648571232 Reassigns benefits to 1 organization
I20180423002919 DC Practitioner - Optometry 0648571232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Maryland LLCGroup PAC ID 6002037629, 121 clinicians

Practice addresses (Care Compare)

14700 Baltimore Ave
Unit 109
Laurel, MD 20707-4878
Phone (301) 245-3903

3715 Boston St
Baltimore, MD 21224-5752
Phone (443) 839-0335

4412 Mitchellville Rd
Bowie, MD 20716-3112
Phone (301) 809-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2452NCMDMental Health Counselor
TA2482MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince May 1, 2018 Accepting new patients
Canton Crossing Optometry, LLC Optometrist CurrentSince Nov 10, 2015 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Nov 1, 2016 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Nov 1, 2016 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince May 1, 2018 Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients

Locations

2321 Forest Dr
Ste E
Annapolis, MD 21401
Phone (410) 266-3369

3715 Boston St
Baltimore, MD 21224
Phone (443) 839-0335

4412 Mitchellville Rd
Bowie, MD 20716
Phone (301) 309-0000

19814 Century Blvd
Germantown, MD 20874
Phone (301) 540-1200

118 Shawan Rd
Hunt Valley, MD 21030
Phone (410) 527-1948

118 Shawan Rd
Ste S
Hunt Valley, MD 21030
Phone (410) 584-8224

14700 Baltimore Ave
Unit 109
Laurel, MD 20707
Phone (301) 245-3903

2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919

12194 Johnston Rd
#102
Charlotte, NC 28277
Phone (704) 541-6287

1823 E Arbors Dr
Ste 325
Charlotte, NC 28262
Phone (704) 971-5000

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

860 Summit Crossing Pl
Ste 110
Gastonia, NC 28054
Phone (704) 865-3937

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1588031793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6804 RACE TRACK RD",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207153011",
            "telephone_number": "301-262-1210",
            "fax_number": "301-352-3568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "860 Summit Crossing Pl Ste 110",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280542217",
            "country_code": "US",
            "telephone_number": "704-865-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "CERINA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2452",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.