Individual provider Active NPI

Syed Hussain

  • Optometrist
  • Laurel, MD
National Provider Identifier
1902031578
Registry record updated Jan 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2142 Issued in MD
Practice address
14700 Baltimore Ave
Laurel, MD 20707-4877
Phone
(301) 245-3903
Fax
(301) 371-3983
NPI assigned
May 26, 2009
Last updated
Jan 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X PENDING MD
Optometrist 152W00000X TA2142 MD Primary

Addresses

Primary practice location

14700 Baltimore Ave
Laurel, MD 20707-4877

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20150608001026 MD Practitioner - Optometry 0345561981 Reassigns benefits to 1 organization
I20171103002020 DC Practitioner - Optometry 0345561981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14811 Baltimore Ave
Laurel, MD 20707-4817
Phone (301) 490-6030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PENDINGMDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Canton Crossing Optometry, LLC Optometrist CurrentSince Jun 6, 2015 Accepting new patients
Clearview Eye Care Optometrist Current Accepting new patients
Laurel Eye Care LLC Optometrist CurrentSince Jun 1, 2023 Accepting new patients
My Eye Dr. Optometrists, LLC Optometrist Past Accepting new patients
Pearle Vision Center PastSince Jun 1, 2023 Accepting new patients

Locations

3715 Boston St
Baltimore, MD 21224
Phone (443) 839-0335

14811 Baltimore Ave
Laurel, MD 20707
Phone (301) 490-6030

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517270400000",
    "number": "1902031578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "866-795-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074877",
            "telephone_number": "301-245-3903",
            "fax_number": "301-371-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "SYED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-26",
        "last_updated": "2018-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.