Joseph L Derose (NPI# 1679516595, PAC ID# 5698741940) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1679516595 |
| PAC ID by PECOS | 5698741940 |
| Professional Enrollment ID | I20040908000541 |
| Full Name | Joseph L Derose |
| Organization Legal Name | MYEYEDR OPTOMETRY OF MARYLAND LLC |
| Address |
14700 Baltimore Ave Unit 109 Laurel MD 20707-4878 |
| Phone Number | 3012453903 |
| Gender | M |
| Credential | OD |
| Medical School | PENNSYLVANIA COLLEGE OF OPTOMETRY |
| Graduation Year | 1987 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 6002037629 |
| Number of Group Practice Members | 45 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 6306 /2 York Rd, Baltimore, MD 21212-2635 | 4438635206 | MYEYEDR OPTOMETRY OF MARYLAND LLC |
| 14700 Baltimore Ave, Unit 109, Laurel, MD 20707-4878 | 3012453903 | MYEYEDR OPTOMETRY OF MARYLAND LLC |
| Organization Legal Name | MYEYEDR OPTOMETRY OF MARYLAND LLC |
| Physicians | 45 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wai Yin Teresa Chang | Optometry | Myeyedr Optometry of Maryland LLC | 1725b Dual Hwy, Hagerstown, MD 21740-6653 |
| Eleanor Siri | Optometry | Myeyedr Optometry of Maryland LLC | 2657 N Salisbury Blvd, Suite 104, Salisbury, MD 21801-2184 |
| Marty J Wyman | Optometry | Myeyedr Optometry of Maryland LLC | 625 Baltimore Blvd, Suite K, Westminster, MD 21157-6183 |
| Larry Rubin | Optometry | Myeyedr Optometry of Maryland LLC | 825 Dulaney Valley Rd, Suite 2135, Towson, MD 21204-2149 |
| Chelsea Ray Dayton | Optometry | Myeyedr Optometry of Maryland LLC | 12101 Winchester Rd, Suite 102, Cumberland, MD 21502-7688 |
| Carol A Schwan | Optometry | Myeyedr Optometry of Maryland LLC | 2321 E Forest Dr, Annapolis, MD 21401-3833 |
| Kristen M Montgomery | Optometry | Myeyedr Optometry of Maryland LLC | 19814 Century Blvd, Germantown, MD 20874-1198 |
| Calvin Osterman | Optometry | Myeyedr Optometry of Maryland LLC | 4412 Mitchellville Rd, Bowie, MD 20716-3112 |
| Robert R Mitter | Optometry | Myeyedr Optometry of Maryland LLC | 6306 /2 York Rd, Baltimore, MD 21212-2635 |
| Eric Goulston | Optometry | Myeyedr Optometry of Maryland LLC | 2936 Festival Way, Suite 409a, Waldorf, MD 20601-2957 |
| Street Address |
14700 BALTIMORE AVE UNIT 109 |
| City | LAUREL |
| State | MD |
| Zip | 20707-4878 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nneka C Oligbo | Physical Therapy | Glen Burnie Physical Therapy and Sportscare LLC | 14700 Baltimore Ave, Suite 106, Laurel, MD 20707-4878 |
| Binh Nguyen | Physical Therapy | Glen Burnie Physical Therapy and Sportscare LLC | 14700 Baltimore Ave, Suite 106, Laurel, MD 20707-4878 |
| Julia Kozyaykina Shoyked | Optometry | Myeyedr Optometry of Maryland LLC | 14700 Baltimore Ave, Unit 109, Laurel, MD 20707-4878 |
| Kelsey Lynn Bellanca | Physical Therapy | Glen Burnie Physical Therapy and Sportscare LLC | 14700 Baltimore Ave, Suite 106, Laurel, MD 20707-4878 |
| Noah L Kubissa | Physical Therapy | Glen Burnie Physical Therapy and Sportscare LLC | 14700 Baltimore Ave, Laurel, MD 20707-4878 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cylburn E Soden | Dermatology | Cylburn E Soden M.d.p.a | 13920 Baltimore Ave, Laurel, MD 20707-2009 |
| Cylburn Soden Jr. | Dermatology | Cylburn E Soden M.d.p.a | 13920 Baltimore Ave, Laurel, MD 20707-2009 |
| Colleen Denise Mitchell | Psychologist, Clinical | 8108 Sandy Spring Rd, Suite 100f, Laurel, MD 20707-3582 | |
| Pamela Dsouza David | Ophthalmology | 8101 Sandy Spring Rd, Suite 106, Laurel, MD 20707-3596 | |
| Lavonne Browne | Psychologist, Clinical | 8101 Sandy Spring Rd, Suite 100f, Laurel, MD 20707-3596 | |
| Rajkumar G. Bhojraj | Family Medicine | 704 Gorman Ave, T1, Laurel, MD 20707-3947 | |
| Sami K Ghannam | Optometry | 612 Main St, Laurel, MD 20707-4008 | |
| Binta Bojang | Nurse Practitioner | Matclinic Physicians Practice Group LLC | 601 7th St, Suite 304, Laurel, MD 20707-4011 |
| Tetyana Evans | Nurse Practitioner | Matclinic Physicians Practice Group LLC | 601 7th St, Suite 304, Laurel, MD 20707-4011 |
| John P Grundy Iii | Ophthalmology | 615 Main St, Laurel, MD 20707-4065 | |
| Find all physicians in zip 20707 | |||
| City | LAUREL |
| Zip Code | 20707 |
| Specialty | OPTOMETRY |
| City + Specialty | LAUREL + OPTOMETRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.