Individual provider Active NPI

Ray Morse Atcherson, O.O.

  • Optometrist
  • Arnold, MD
National Provider Identifier
1902821838
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TAO 740 Issued in MD
Practice address
1294 Bay Dale Dr
Arnold, MD 21012-2325
Phone
(410) 757-1350
Fax
(410) 757-7835
NPI assigned
Jul 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TAO 740 MD Primary

Addresses

Primary practice location

1294 Bay Dale Dr
Arnold, MD 21012-2325

Mailing address

1294 Bay Dale Dr
Arnold, MD 21012-2325
Phone (410) 757-1350

Other identifiers 1

IdentifierTypeStateIssuer
980078600MedicaidMD

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
I20110318000027 MD Practitioner - Optometry 6204040884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Ray M Atcherson PAGroup PAC ID 5395959977, 4 clinicians

Practice addresses (Care Compare)

1294 Bay Dale Dr
Arnold, MD 21012-2325
Phone (410) 757-1350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Ray M Atcherson PA CurrentSince Jan 1, 2000 Accepting new patients

Locations

1294 Bay Dale Dr
Arnold, MD 21012
Phone (410) 757-1350

Organizations & group practices 1

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902821838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 BAY DALE DR",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210122325",
            "telephone_number": "410-757-1350",
            "fax_number": "410-757-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 BAY DALE DR",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210122325",
            "telephone_number": "410-757-1350",
            "fax_number": "410-757-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATCHERSON",
        "first_name": "RAY",
        "middle_name": "MORSE",
        "name_prefix": "Dr.",
        "credential": "O.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TAO 740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "980078600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arnold, MD

Sources for this page

Verify at the official NPI Registry.