Individual provider Active NPI

Benjamin Allan Hartz, OD

  • Optometrist
  • Greenbelt, MD
National Provider Identifier
1821002387
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA0863 Issued in MD
Practice address
7551 Greenbelt Rd
Greenbelt, MD 20770-3403
Phone
(301) 807-1174
Fax
(301) 982-2300
NPI assigned
Jul 28, 2006
Last updated
Oct 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0512 DC
Optometrist 152W00000X TA0863 MD Primary

Addresses

Primary practice location

7551 Greenbelt Rd
Greenbelt, MD 20770-3403

Mailing address

2811 Lord Baltimore Dr
Baltimore, MD 21244
Phone (443) 316-2101

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

LicenseStateTypeSpecialty
0512DCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Luxottica of America Inc PastSince Oct 29, 2023 Accepting new patients
Spectera Past Accepting new patients

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1821002387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 LORD BALTIMORE DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21244",
            "telephone_number": "443-316-2101",
            "fax_number": "410-265-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7551 GREENBELT RD",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703403",
            "telephone_number": "301-807-1174",
            "fax_number": "301-982-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTZ",
        "first_name": "BENJAMIN",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DC",
            "license": "0512",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA0863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.