Individual provider Active NPI

Brett Kline

  • Optometrist
  • Easton, MD
National Provider Identifier
1912696311
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2999 Issued in MD
Practice address
405 Marvel CT
Easton, MD 21601-4053
Phone
(410) 822-9801
Fax
(410) 822-9805
NPI assigned
May 2, 2023
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X I3-0011467 DE
Optometrist 152W00000X TA2999 MD Primary

Addresses

Primary practice location

405 Marvel CT
Easton, MD 21601-4053

Mailing address

405 Marvel CT
Easton, MD 21601-4053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, 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
I20240227003869 DE Practitioner - Optometry 4082059274 Reassigns benefits to 1 organization
I20240701003579 MD Practitioner - Optometry 4082059274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zuleika M Ghodsi, MD, PCGroup PAC ID 3678462421, 3 clinicians

Practice addresses (Care Compare)

405 Marvel CT
Easton, MD 21601-4053
Phone (410) 822-9801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I3-0011467DEMDOptometrist
TA2999MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Delaware PA Optometrist Current Accepting new patients
Myeyedr Optometry of Delaware PA Optometrist CurrentSince Jan 16, 2024 Accepting new patients
Zuleika M Ghodsi, MD, PC CurrentSince Aug 15, 2024 Accepting new patients
Myeyedr Optometry of Delaware PA Optometrist CurrentSince Jan 16, 2024 Accepting new patients

Locations

885 S Governors Ave
Dover, DE 19904
Phone (302) 734-5861

1301 Bridgeville Hwy
Seaford, DE 19973
Phone (302) 629-9197

401 Marvel Ct
Ste B
Easton, MD 21601
Phone (410) 822-9801

405 Marvel Ct
Easton, MD 21601
Phone (410) 822-9801

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: brettrkline@delmarvaeye.direct.eyemdemr.com

Organizations & group practices 4

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": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1912696311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MARVEL CT",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216014053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MARVEL CT",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216014053",
            "telephone_number": "410-822-9801",
            "fax_number": "410-822-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "BRETT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-02",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DE",
            "license": "I3-0011467",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

Verify at the official NPI Registry.