Individual provider Active NPI

Jane Choi Council, O.D.

  • Optometrist
  • Gambrills, MD
National Provider Identifier
1780949693
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2652 Issued in MD
Practice address
1127 MD RT 3 N Unit 104
Gambrills, MD 21054-1715
Phone
(410) 988-2662
Fax
(410) 988-4553
NPI assigned
Jul 6, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Panoptic Eye Care LLC 2 clinicians
Aeg Maryland Professional LLC 20 clinicians
BFT Vision Inc 6 clinicians

Practice addresses (Care Compare)

1127 State Route 3 N
Suite 104
Gambrills, MD 21054-1715
Phone (410) 988-2662

139 Ritchie Hwy
Severna Park, MD 21146-1152
Phone (410) 544-7417

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
I20221123000070 MD Practitioner - Optometry 3678707304 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA2652MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
BFT Vision Inc Optometrist CurrentSince Nov 1, 2022 Accepting new patients
Aeg Maryland Professional LLC Optometrist CurrentSince Apr 20, 2025 Accepting new patients
Bridgeport Eye Care, LLC Optometrist PastSince Aug 1, 2018 Accepting new patients
Panoptic Eye Care, LLC Optometrist Past Accepting new patients

Locations

409 W Cold Spring Ln
Baltimore, MD 21210
Phone (410) 243-5656

73 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 662-1601

139 Ritchie Hwy
Ste B
Severna Park, MD 21146
Phone (410) 544-4717

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2652 MD Primary

Addresses

NPPES NPI Registry

Primary practice location

1127 MD RT 3 N Unit 104
Gambrills, MD 21054-1715

Mailing address

1127 MD RT 3 N Unit 104
Gambrills, MD 21054-1715
Phone (410) 988-2662

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
046010582MedicaidIL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 29, 2026.

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1780949693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 MD RT 3 N UNIT 104",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541715",
            "telephone_number": "410-988-2662",
            "fax_number": "410-955-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 MD RT 3 N UNIT 104",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541715",
            "telephone_number": "410-988-2662",
            "fax_number": "410-988-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUNCIL",
        "first_name": "JANE",
        "middle_name": "CHOI",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010582",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gambrills, MD

Sources for this page

Verify at the official NPI Registry.