Organization Active NPI

Wink Eyecare Boutique, LLC

  • Optometrist
  • Potomac, MD
National Provider Identifier
1952080145
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WINK EYECARE BOUTIQUE, LLC
Doing business as
WINK EYECARE
Practice address
1095 Seven Locks Rd
Potomac, MD 20854-2903
Phone
(301) 545-1111
Fax
(301) 545-1717
NPI assigned
Jul 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Authorized official

Name
Dr. Rachel B Cohn, ODNPI 1457479834
Title
Owner, Authorized Official
Phone
(301) 545-1111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1095 Seven Locks Rd
Potomac, MD 20854-2903

Mailing address

1095 Seven Locks Rd
Potomac, MD 20854-2903
Phone (301) 545-1111

Other names 1

  • WINK EYECARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231009000974 DC Part B Supplier - Clinic/Group Practice 3274988498 Receives reassigned benefits from 2 practitioners
Practice locations: Potomac, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2114013Wink Eyecare Boutique1095 Seven Locks Rd, Potomac, MD 20854Certificate of waiverJun 5, 2028

National Provider Directory

National Provider Directory

Locations

1095 Seven Locks Rd
Potomac, MD 20854
Phone (301) 545-1111

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1952080145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 SEVEN LOCKS RD",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208542903",
            "telephone_number": "301-545-1111",
            "fax_number": "301-545-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 SEVEN LOCKS RD",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208542903",
            "telephone_number": "301-545-1111",
            "fax_number": "301-545-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINK EYECARE BOUTIQUE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-14",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "COHN",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER, AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "301-545-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WINK EYECARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Potomac, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.