DR. IRVIN R MADURO (NPI# 1417018946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417018946 |
| Entity Type | Individual |
| Full Name | DR. IRVIN R MADURO |
| Credential | MD |
| Practice Address |
6014 Old Branch Ave Kaiser Permanente Camp Springs Medical Center Temple Hills MD 20748-2518 |
| Mailing Address |
2101 E Jefferson St Ppqa Medicare Compliance Unit 6 W Kaiser Permanente Mid Atlantic Permanente Medical Group Rockville MD 20852-4908 |
| Practice Telephone | 3017026100 |
| Practice Fax Number | 3017026366 |
| Mailing Telephone | 3018166660 |
| Mailing Fax Number | 3018166308 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2011-12-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152WP0200X |
Optometrist Specialization: Pediatrics |
MD22166 | DC | Eye and Vision Services Providers |
| Y | 152WP0200X |
Optometrist Specialization: Pediatrics |
D0038713 | MD | Eye and Vision Services Providers |
| Street Address |
6014 OLD BRANCH AVE KAISER PERMANENTE CAMP SPRINGS MEDICAL CENTER |
| City | TEMPLE HILLS |
| State | MD |
| Zip Code | 20748-2518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316579873 | Brightway Professionals and Associates | Clinic/Center | 4810 St.barnabas Rd, Suite 201, Temple Hills, MD 20748 | 2020-02-12 |
| 1235783085 | Jasmine Lenee Carter | Behavior Technician | 5506 Clothier St., Temple Hills, MD 20748 | 2019-07-30 |
| 1649760075 | Livewell Family Clinic LLC | Clinic/Center | 3611 Branch Ave Ste 404, Temple Hills, MD 20748 | 2018-05-10 |
| 1346785474 | Cardinal Health Care Solution LLC | Home Health | 4905 Faith Crossin Ct, Templehills, MD 20748 | 2016-12-28 |
| 1205370095 | Crystal Hughes | Specialist | 6337 Old Branch Ave Shop 37, Camp Springs, MD 20748 | 2016-12-13 |
| 1417385444 | Ibhs LLC | Substance Abuse Rehabilitation Facility | 5000 Barnabas Road, Ct2, Temple Hills, MD 20748 | 2013-10-30 |
| 1063848703 | Oluwagbenga Jegede | Home Health Aide | 6516 Allentown Rd, Temple Hills, MD 20748 | 2013-09-25 |
| 1184067514 | Vijaya Lakshmi Alla | Family Medicine | 6014 Old Branch Avenue, Temple Hills, MD 20748 | 2013-04-16 |
| 1215178959 | Patricia Ann Carter | Counselor | 5121 Henderson Road, Suite 101, Temple Hills, MD 20748 | 2009-03-10 |
| 1427220888 | Emerging Vision | Technician/Technologist | 3801 D Branch Ave, Iverson Mall, Temple Hills, MD 20748 | 2008-03-26 |
| Find all providers in zip 20748 | ||||
| Taxonomy Code | 152WP0200X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Pediatrics |
| Optometrists who work in Pediatrics are concerned with the prevention, development, diagnosis, and treatment of visual problems in children. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023184215 | Chinyere Wogu Dike | Optometrist | 6104 Old Branch Avenue, Temple Hills, MD 20748-2518 | 2006-11-28 |
| 1275606568 | Andrea Karin Prosser | Optometrist | 6104 Old Branch Avenue, Temple Hills, MD 20748-2518 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780989335 | Hangxiu Xu | Optometrist | 3129 Normandy Woods Dr Apt D, Ellicott City, MD 21043-4582 | 2011-01-12 |
| 1104885037 | Amanda Rae Zeller Manley | Optometrist | 6900 Wisconsin Ave, Suite 600, Chevy Chase, MD 20815-6114 | 2006-03-20 |
| 1154300309 | Diane Serex-dougan | Optometrist | 7954 Harford Rd, Baltimore, MD 21234-5838 | 2006-01-14 |
| 1265997522 | Kelsey Starman | Optometrist | 6509 Democracy Blvd, Bethesda, MD 20817-1639 | 2019-01-31 |
| 1285126011 | Diane Serex-dougan, O.d. | Optometrist | 7954 Harford Rd, Baltimore, MD 21234-5838 | 2018-06-06 |
| 1598045957 | Vision and Conceptual Development Center LLC | Optometrist | 6900 Wisconsin Ave, Suite 600, Chevy Chase, MD 20815-6114 | 2011-08-17 |
| 1477856474 | Vision and Conceptual Development Center LLC | Optometrist | 6900 Wisconsin Ave, Suite 600, Chevy Chase, MD 20815-6114 | 2010-12-13 |
| 1033424791 | Eleanor Kim Min | Optometrist | 1209 York Rd, Suite 200, Lutherville, MD 21093-6220 | 2010-08-18 |
| 1104013747 | Jill Meredith Vocci | Optometrist | 2 Hamill Rd, Suite 345, Baltimore, MD 21210-1806 | 2007-09-27 |
| 1750578498 | Sharon Choi Oh | Optometrist | 2 Hamill Rd, Suite 345, Baltimore, MD 21210-1806 | 2007-09-26 |
| Find all providers with the same taxonomy | ||||
| City | TEMPLE HILLS |
| Zip Code | 20748 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.