Thomas S. Ruppert, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TA1015 Issued in MD

Practice address

12500 Country Club Mall Rd
Lavale, MD 21502-7518

Phone

(301) 729-5091

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609988765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10105 KEATLEY DR SW",
            "city": "LAVALE",
            "state": "MD",
            "postal_code": "215026155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 COUNTRY CLUB MALL RD",
            "city": "LAVALE",
            "state": "MD",
            "postal_code": "215027518",
            "telephone_number": "301-729-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPPERT",
        "first_name": "THOMAS",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Riley, D.O.
• Haley Hixon Rodeheaver, AUD
• Diana Roderick
• Rosario Gonzaga, MD PA
• Evelyn Virginia Rowland, PHARM.D.
• Valerie Anne Ryan, DDS
• Aimee Saville, PHARMD
• Amy Schwab Owens, MS, LCPC
• Danielle Nadine Sheally
• Kshitij K Singam

• Optometrist in Lavale, MD
• Providers in Lavale, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.