Individual provider Active NPI

Ross Fischer, O.D.

  • Optometrist
  • Baltimore, MD
National Provider Identifier
1720173594
Registry record updated Mar 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA0685 Issued in MD
Practice address
100 Park Ave
Baltimore, MD 21201-3416
Phone
(410) 752-1677
Fax
(410) 752-4435
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA0685 MD Primary

Addresses

Primary practice location

100 Park Ave
Baltimore, MD 21201-3416

Mailing address

100 Park Ave
Baltimore, MD 21201-3416
Phone (410) 752-1677

Other identifiers 2

IdentifierTypeStateIssuer
S017-0005OtherMDBLUE CHOICE
686551OtherMDBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131210000126 MD Practitioner - Optometry 1557259645 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Barenburg Optical Service, Inc Optometrist CurrentSince May 9, 2001 Accepting new patients

Locations

100 Park Ave
Baltimore, MD 21201
Phone (410) 727-0285

Organizations & group practices 1

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1720173594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212013416",
            "telephone_number": "410-752-1677",
            "fax_number": "410-752-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212013416",
            "telephone_number": "410-752-1677",
            "fax_number": "410-752-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "ROSS",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA0685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "S017-0005",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "686551",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.