Individual provider Active NPI

Hannah Kim, OD

  • Optometrist
  • Clarksburg, MD
National Provider Identifier
1891987723
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2049 Issued in MD
Practice address
22610 Newcut Rd Ste E4A
Clarksburg, MD 20871-5332
Phone
(301) 874-5777
Fax
(301) 874-5777
NPI assigned
Aug 14, 2007
Last updated
Jan 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001656 VA
Optometrist 152W00000X TA2049 MD Primary

Addresses

Primary practice location

22610 Newcut Rd Ste E4A
Clarksburg, MD 20871-5332

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080215000436 DC Practitioner - Optometry 6608959515 Reassigns benefits to 2 organizations
I20090105000347 MD Practitioner - Optometry 6608959515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Maryland LLCGroup PAC ID 6002037629, 121 clinicians

Practice addresses (Care Compare)

19814 Century Blvd
Germantown, MD 20874-1198
Phone (301) 540-1200

5500 Buckeystown Pike
Suite 620
Frederick, MD 21703-9458
Phone (301) 663-4745

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA2049MDMDOptometrist
0618001656VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince May 13, 2020 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince May 13, 2020 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Rockville Optometry, LLC Optometrist CurrentSince May 13, 2020 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince May 13, 2020 Accepting new patients

Locations

22610 Newcut Rd
Ste E4A
Clarksburg, MD 20871
Phone (301) 874-5777

6455 Dobbin Rd
Ste 47
Columbia, MD 21045
Phone (443) 542-5999

5500 Buckeystown Pike
Ste 620
Frederick, MD 21703
Phone (301) 663-4745

7810 Wormans Mill Rd
Ste C
Frederick, MD 21701
Phone (301) 228-2666

80 Market St
Gaithersburg, MD 20878
Phone (301) 990-1122

19814 Century Blvd
Germantown, MD 20874
Phone (301) 540-1200

20946 Frederick Rd
Unit A
Germantown, MD 20876
Phone (240) 361-9600

18111 Town Center Dr
Olney, MD 20832
Phone (301) 570-1600

14929 Shady Grove Rd
Unit K
Rockville, MD 20850
Phone (301) 424-1050

8529 Georgia Ave
Silver Spring, MD 20910
Phone (301) 588-3232

2936 Festival Way
Ste 409A
Waldorf, MD 20601
Phone (301) 710-6919

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 6

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": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1891987723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22610 NEWCUT RD STE E4A",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208715332",
            "telephone_number": "301-874-5777",
            "fax_number": "301-874-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HANNAH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001656",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksburg, MD

Sources for this page

Verify at the official NPI Registry.