Individual provider Active NPI

Martin Lee Tomko, OD

  • Optometrist
  • Baltimore, MD
National Provider Identifier
1912911470
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1094 Issued in MD
Practice address
6630 Security Blvd
Baltimore, MD 21207
Phone
(410) 298-4040
Fax
(410) 298-4167
NPI assigned
Jul 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1094 MD Primary
Optometrist 152W00000X OP668 DC

Addresses

Primary practice location

6630 Security Blvd
Baltimore, MD 21207

Mailing address

2811 Lord Baltimore Dr
Baltimore, MD 21244
Phone (443) 316-2101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OP668DCMDOptometrist
TA1094MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spectera Past Accepting new patients

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912911470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 LORD BALTIMORE DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21244",
            "telephone_number": "443-316-2101",
            "fax_number": "410-265-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 SECURITY BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21207",
            "telephone_number": "410-298-4040",
            "fax_number": "410-298-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMKO",
        "first_name": "MARTIN",
        "middle_name": "LEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1094",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DC",
            "license": "OP668",
            "primary": false
        }
    ],
    "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.