Eliahu Bruck, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TAO877 Issued in MD

Practice address

2963 Manchester Rd Ste B
Manchester, MD 21102-1853

Phone

(410) 239-6700

Fax

(410) 239-6720

NPI assigned

Jun 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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 1

Specialty

Optometry

Education

Southern College of Optometry, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DRS. Blum and Bruck, O.D. P.a.Group PAC ID 9638299415, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• DRS. Blum & Bruck, O.D. P.a.

  • Optometrist
  • Manchester, MD
  • NPI 1326234337

  MD

  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244678400000",
    "number": "1992743678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 ASHLEY WAY",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211171442",
            "telephone_number": "410-356-7290",
            "fax_number": "410-239-6720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2963 MANCHESTER RD STE B",
            "city": "MANCHESTER",
            "state": "MD",
            "postal_code": "211021853",
            "telephone_number": "410-239-6700",
            "fax_number": "410-239-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCK",
        "first_name": "ELIAHU",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2009-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TAO877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kimberly Lois Davis, FNP-C

• All providers in Manchester, MD
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.