NPIMap

Organization Active NPI

Eyecare Professionals P C

  • Optometrist
  • Hagerstown, MD
National Provider Identifier
1962553818
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA0918 Issued in MD
Legal business name
EYECARE PROFESSIONALS P C
Practice address
101 Eastern Blvd N
Hagerstown, MD 21740-5978
Phone
(240) 420-8888
Fax
(240) 420-8400
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2012

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

Authorized official

Name
Dr. Rose Navin Wood, O.D.NPI 1063525681
Title
Optometrist
Phone
(240) 420-8888

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 TA0918 MD Primary

Addresses

Primary practice location

101 Eastern Blvd N
Hagerstown, MD 21740-5978

Mailing address

101 Eastern Blvd N
Hagerstown, MD 21740-5978
Phone (240) 420-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040805001571 MD Part B Supplier - Clinic/Group Practice 5698746170 Receives reassigned benefits from 5 practitioners
Practice locations: Hagerstown, MD
O20100930003784 MD DME Supplier - Physician - Optometrist 5698746170 Practice locations: Hagerstown, 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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eyecare Professionals101 Eastern Blvd N, Hagerstown, MD 21740-5978(240) 420-8888 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Aug 24, 2001

National Provider Directory

National Provider Directory

Locations

91 Eastern Blvd N
Hagerstown, MD 21740
Phone (240) 420-8888

Interoperability endpoints

  • Direct secure messaging: lwood@eyecareprofessionals.eyefinity-direct.com
  • Direct secure messaging: rwood@eyecareprofessionals.eyefinity-direct.com

Practitioners & affiliated clinicians

Practitioners 6

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": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333670400000",
    "number": "1962553818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 EASTERN BLVD N",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405978",
            "telephone_number": "240-420-8888",
            "fax_number": "240-420-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 EASTERN BLVD N",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405978",
            "telephone_number": "240-420-8888",
            "fax_number": "240-420-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE PROFESSIONALS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2012-04-06",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "NAVIN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "240-420-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA0918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; 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.