Vincent Bertomeu, OD, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001167 Issued in VA

Legal business name

VINCENT BERTOMEU, OD, PC

Practice address

6506 Loisdale Rd
Ste 102
Springfield, VA 22150-1824

Phone

(703) 719-9110

Fax

(703) 719-9040

NPI assigned

Aug 7, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vencent Anthony Bertomeu, OD

Title

President

Phone

(703) 719-9110

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013926880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6506 LOISDALE RD",
            "address_2": "STE 102",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221501824",
            "telephone_number": "703-719-9110",
            "fax_number": "703-719-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6506 LOISDALE RD",
            "address_2": "STE 102",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221501824",
            "telephone_number": "703-719-9110",
            "fax_number": "703-719-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINCENT BERTOMEU, OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERTOMEU",
        "authorized_official_first_name": "VENCENT",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-719-9110",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.