Individual provider Active NPI

Maria Sklavos Servinsky, O.D.

  • Optometrist
  • Bowie, MD
National Provider Identifier
1710083258
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1891 Issued in MD
Practice address
17001 Science Dr
Suite 120
Bowie, MD 20715-4329
Phone
(301) 860-7090
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1891 MD Primary

Addresses

Primary practice location

17001 Science Dr
Suite 120
Bowie, MD 20715-4329

Mailing address

17001 Science Dr Ste 120
Bowie, MD 20715-4330
Phone (301) 860-1090

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mariaservinskyod@glaucomacenter.direct.eyemdemr.com Direct

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
I20120621000399 MD Practitioner - Optometry 2668448994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joanne Brilliant O.D., P.a.Group PAC ID 7911976725, 2 clinicians

Practice addresses (Care Compare)

1410 Forest Dr
Suite 1
Annapolis, MD 21403-1442
Phone (410) 295-3010

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Joanne Brilliant O.D., P.a. Optometrist CurrentSince Dec 1, 2021 Accepting new patients
Paul a Tarantino, M.D.,P.a. CurrentSince Sep 8, 2021 Accepting new patients

Locations

1410 Forest Dr
Annapolis, MD 21403
Phone (410) 280-8774

1410 Forest Dr
Ste 1
Annapolis, MD 21403
Phone (410) 295-1500

806 Landmark Dr
Ste 114
Glen Burnie, MD 21061
Phone (410) 590-9260

Interoperability endpoints

  • Direct secure messaging: mariaservinskyod@glaucomacenter.direct.eyemdemr.com

Organizations & group practices 2

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1710083258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17001 SCIENCE DR STE 120",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154330",
            "telephone_number": "301-860-1090",
            "fax_number": "301-860-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17001 SCIENCE DR",
            "address_2": "SUITE 120",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154329",
            "telephone_number": "301-860-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVINSKY",
        "first_name": "MARIA",
        "middle_name": "SKLAVOS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-09-03",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mariaservinskyod@glaucomacenter.direct.eyemdemr.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging  to EyeMD EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "17001 Science Dr",
            "address_2": "Suite 120",
            "city": "Bowie",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207154329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.