Active NPI
Benjamin I Hendin, OD
- Optometrist
- Ellicott City, MD
National Provider Identifier
1700979796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 665
- Practice address
- 9150 Baltimore National Pike
Ste 15
Ellicott City, MD 21042 - Phone
- (410) 465-6166
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 665 | MD | Primary |
Addresses
Primary practice location
9150 Baltimore National Pike
Ste 15
Ellicott City, MD 21042
Mailing address
9150 Baltimore National Pike
Professional Vision Ste 15
Ellicott City, MD 21042
Phone (410) 465-6166
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11248579 | Other | CAQH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 665 | MD | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267488000000",
"number": "1700979796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9150 BALTIMORE NATIONAL PIKE",
"address_2": "PROFESSIONAL VISION STE 15",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "21042",
"telephone_number": "410-465-6166",
"fax_number": "410-465-8898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9150 BALTIMORE NATIONAL PIKE",
"address_2": "STE 15",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "21042",
"telephone_number": "410-465-6166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDIN",
"first_name": "BENJAMIN",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2010-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MD",
"license": "665",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11248579",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.