Organization Active NPI

Beach Eye Care, Inc.

  • Optometrist
  • Virginia Beach, VA
National Provider Identifier
1013902873
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BEACH EYE CARE, INC.
Practice address
1201 First Colonial Rd
Virginia Beach, VA 23454-2217
Phone
(757) 425-5550
Fax
(757) 412-2606
NPI assigned
Sep 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Dr. Vivek Jain, MDNPI 1487649687
Title
President
Phone
(757) 425-5550

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 MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1201 First Colonial Rd
Virginia Beach, VA 23454-2217

Mailing address

1201 First Colonial Rd
Virginia Beach, VA 23454-2217
Phone (757) 425-5550

Other identifiers 4

IdentifierTypeStateIssuer
0618002731OtherVASTATE LICENSE
89015YKOtherNC MEDICAID
CL3147OtherVAMEDICARE RAILROAD
010147859MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041206001107 VA Part B Supplier - Clinic/Group Practice 8921064460 Receives reassigned benefits from 15 practitioners
Practice locations: Chesapeake, VA; Virginia Beach, VA

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2046402Beach Eye Care1201 First Colonial Rd, Virginia Beach, VA 23454Certificate of waiverSep 2, 2026

National Provider Directory

National Provider Directory

Locations

1501 Cedar Rd
Unit 113
Chesapeake, VA 23322
Phone (757) 425-5550

325 Volvo Pkwy
Ste 120
Chesapeake, VA 23320

1501 Cedar Rd
Chesapeake, VA 23322

4388 Holland Rd
Virginia Beach, VA 23452
Phone (757) 425-5550

5386 Kempsriver Dr
Ste 101
Virginia Beach, VA 23464
Phone (757) 420-2001

4388 Holland Rd
Ste 140
Virginia Beach, VA 23452
Phone (757) 425-5550

2173 Upton Dr
Ste 601
Virginia Beach, VA 23454
Phone (757) 351-2020

5386 Kempsriver Dr
Virginia Beach, VA 23464

1201 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 425-5550

2173 Upton Dr
Virginia Beach, VA 23454

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1013902873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 FIRST COLONIAL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542217",
            "telephone_number": "757-425-5550",
            "fax_number": "757-412-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 FIRST COLONIAL RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542217",
            "telephone_number": "757-425-5550",
            "fax_number": "757-412-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH EYE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-16",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "VIVEK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-425-5550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0618002731",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAID",
            "identifier": "89015YK",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CL3147",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010147859",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.