NPIMap

Organization Active NPI

Greater Baltimore Vitreoretinal Specialists, LLC

  • Retina Specialist (Ophthalmology) Physician
  • Baltimore, MD
National Provider Identifier
1831620020
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
D74532 Issued in MD
Legal business name
GREATER BALTIMORE VITREORETINAL SPECIALISTS, LLC
Practice address
2327 Boston St
Unit 1
Baltimore, MD 21224-3672
Phone
(617) 818-0060
NPI assigned
Mar 21, 2017
Last updated
May 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Authorized official

Name
Dr. Christina Antonopoulos, MDNPI 1992820641
Title
President
Phone
(617) 818-0060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X D74532 MD Primary

Addresses

Primary practice location

2327 Boston St
Unit 1
Baltimore, MD 21224-3672

Mailing address

PO Box 5280
6221 Eastern Ave
Baltimore, MD 21224-9998
Phone (617) 818-0060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170719001095 MD Part B Supplier - Clinic/Group Practice 4688944952 Receives reassigned benefits from 1 practitioner
Practice locations: Nottingham, MD; Pikesville, MD; Towson, MD; Westminster, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1831620020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5280",
            "address_2": "6221 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212249998",
            "telephone_number": "617-818-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2327 BOSTON ST",
            "address_2": "UNIT 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243672",
            "telephone_number": "617-818-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER BALTIMORE VITREORETINAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-21",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "ANTONOPOULOS",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-818-0060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MD",
            "license": "D74532",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 10, 2017; 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.