Panoptic Eye Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PANOPTIC EYE CARE, LLC

Practice address

1127 MD RT 3 N Unit 104
Gambrills, MD 21054-1715

Phone

(410) 988-2662

Fax

(410) 988-4553

NPI assigned

Sep 19, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Tiffany Koon, ODNPI 1760820054

Title

Optometrist/Ceo

Phone

(410) 988-2662

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 2

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

• Tiffany Koon, O.D.

  • Optometrist
  • Gambrills, MD
  • NPI 1760820054
  Medicare reassignment Care Compare group NPD Authorized official
• Jane Choi Council, O.D.

  • Optometrist
  • Gambrills, MD
  • NPI 1780949693
  Medicare reassignment Care Compare group NPD (past)

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569196800000",
    "number": "1972087591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 MD RT 3 N # 104",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541715",
            "telephone_number": "410-988-2662",
            "fax_number": "410-988-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 MD RT 3 N UNIT 104",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541715",
            "telephone_number": "410-988-2662",
            "fax_number": "410-988-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANOPTIC EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-19",
        "last_updated": "2019-09-23",
        "status": "A",
        "authorized_official_last_name": "KOON",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OPTOMETRIST/CEO",
        "authorized_official_telephone_number": "410-988-2662",
        "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": []
}

• Jumoke Fadeke Omisore, NP
• Rachell Roda Flores Oncena
• Kenneth Oseleononmen
• Adeyosola Oludara Oyewale
• Varsha Padmanabhan, D.D.S
• Karen Parker Davidson, RN
• Kinjal Patel, OT
• Nishith G Patel, OD
• Susan Kathleen Todd Peeler, MD
• Joy Peterson, FNP-C

• Optometrist in Gambrills, MD
• Providers in Gambrills, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.