Individual provider Active NPI

Bridget A. Blandina, O.D.

  • Optometrist
  • Ellicott City, MD
National Provider Identifier
1629178223
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA 1331 Issued in MD
Practice address
3200 N Ridge Rd
Ellicott City, MD 21043-3363
Phone
(410) 418-5112
NPI assigned
Sep 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG004090 PA
Optometrist 152W00000X TA 1331 MD Primary

Addresses

Primary practice location

3200 N Ridge Rd
Ellicott City, MD 21043-3363

Mailing address

3200 N Ridge Rd
Ellicott City, MD 21043-3363
Phone (410) 418-5112

Other practice location 1

44 E Broad St
Bethlehem, PA 18018-5947
Phone (610) 867-0588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20241012000011 PA Practitioner - Optometry 7810118775 Reassigns benefits to 1 organization
Practice locations: Pittston, PA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

390 Route 315 Hwy
Pittston, PA 18640

390 Route 315 Hwy
Pittston, PA 18640-3903
Phone (570) 883-9696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA 1331MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Oct 1, 2024 Accepting new patients
Myeyedr Optometry of Pennsylvania, LLC Optometrist CurrentSince Oct 1, 2024 Accepting new patients

Locations

44 E Broad St
Bethlehem, PA 18018
Phone (570) 420-4551

125 S Antrim Way
Greencastle, PA 17225
Phone (717) 597-4780

2842 S Eagle Rd
Newtown, PA 18940
Phone (215) 579-1155

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1629178223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 N RIDGE RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433363",
            "telephone_number": "410-418-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 N RIDGE RD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433363",
            "telephone_number": "410-418-5112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180185947",
            "country_code": "US",
            "telephone_number": "610-867-0588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANDINA",
        "first_name": "BRIDGET",
        "middle_name": "A.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-23",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG004090",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA 1331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.