Individual provider Active NPI

Stephen C Flemke, OD

  • Optometrist
  • Cockeysville, MD
National Provider Identifier
1750553053
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA 1053 Issued in MD
Practice address
10255 York Rd
Cockeysville, MD 21030-3201
Phone
(410) 666-0610
Fax
(410) 666-2146
NPI assigned
Mar 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA 1053 MD Primary

Addresses

Primary practice location

10255 York Rd
Cockeysville, MD 21030-3201

Mailing address

10255 York Rd
Cockeysville, MD 21030-3201
Phone (410) 666-0610

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
I20060126000184 MD Practitioner - Optometry 7618981960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10255 York Rd
Cockeysville, MD 21030-3201
Phone (410) 666-0610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA 1053MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen C. Flemke,O.D.,P.a. Optometrist CurrentSince Feb 1, 1998 Accepting new patients
Maas Opticians Inc Optometrist Past Accepting new patients

Locations

6030 Daybreak Cir
Ste A550
Clarksville, MD 21029
Phone (410) 531-7920

18 Cranbrook Rd
Cockeysville, MD 21030
Phone (410) 666-0610

10255 York Rd
Cockeysville, MD 21030
Phone (410) 666-0610

907 W 7th St
Frederick, MD 21701
Phone (301) 662-1451

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1750553053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10255 YORK RD",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210303201",
            "telephone_number": "410-666-0610",
            "fax_number": "410-666-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10255 YORK RD",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210303201",
            "telephone_number": "410-666-0610",
            "fax_number": "410-666-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMKE",
        "first_name": "STEPHEN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-26",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA 1053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cockeysville, MD

Sources for this page

Verify at the official NPI Registry.