Individual provider Active NPI

Melanie C Rennie, O.D.

  • Optometrist
  • Mount Airy, MD
National Provider Identifier
1588970743
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2190 Issued in MD
Practice address
1517 Ridgeside Dr
Mount Airy, MD 21771-5285
Phone
(301) 829-2221
NPI assigned
Aug 26, 2010
Last updated
Jun 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2190 MD Primary

Addresses

Primary practice location

1517 Ridgeside Dr
Mount Airy, MD 21771-5285

Mailing address

1517 Ridgeside Dr
Mount Airy, MD 21771-5285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20111129000277 MD Practitioner - Optometry 2163696287 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mt. Airy Eye Care, LLCGroup PAC ID 4880644301, 4 clinicians
Eldersburg Eye Care LLCGroup PAC ID 0143602425, 4 clinicians

Practice addresses (Care Compare)

1507 S Main St
Mount Airy, MD 21771-5393
Phone (301) 829-2221

5957 Exchange Dr
Suite 114
Eldersburg, MD 21784-9260
Phone (410) 552-7777

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA2190MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eldersburg Eye Care, LLC Optometrist CurrentSince Aug 1, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5957 Exchange Dr
Ste 114
Eldersburg, MD 21784
Phone (410) 552-7777

1507 S Main St
Mount Airy, MD 21771
Phone (301) 829-2221

Organizations & group practices 3

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": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1588970743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 RIDGESIDE DR",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217715285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 RIDGESIDE DR",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217715285",
            "telephone_number": "301-829-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNIE",
        "first_name": "MELANIE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, MD

Sources for this page

Verify at the official NPI Registry.