Individual provider Active NPI

Gregory Katchuk, OD

  • Optometrist
  • Bethesda, MD
National Provider Identifier
1023190030
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA-1679 Issued in MD
Practice address
4300 East West Highway
Bethesda, MD 20814
Phone
(301) 656-0775
Fax
(301) 656-5164
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001165 VA
Optometrist 152W00000X TA-1679 MD Primary

Addresses

Primary practice location

4300 East West Highway
Bethesda, MD 20814

Mailing address

1950 Old Gallows Rd 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040504000722 VA Practitioner - Optometry 8325036866 Reassigns benefits to 2 organizations
I20040510000904 DC Practitioner - Optometry 8325036866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4300 E W Hwy
Bethesda, MD 20814-4433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA-1679MDMDOptometrist
0618001165VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Virginia PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Jun 16, 2015 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Jun 16, 2015 Accepting new patients
Dulles Optometry, LLC Optometrist CurrentSince Jun 16, 2015 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Sep 5, 2023 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist Current Accepting new patients

Locations

2823 Clarendon Blvd
Arlington, VA 22201
Phone (703) 294-6600

1211 S Fern St
Arlington, VA 22202
Phone (703) 888-2999

44727 Brimfield Dr
Ashburn, VA 20147
Phone (571) 385-4600

5765 Burke Centre Pkwy
Ste L
Burke, VA 22015
Phone (703) 250-2000

14245P Centreville Sq
Centreville, VA 20121
Phone (703) 830-2010

2910 District Ave
Ste 160
Fairfax, VA 22031
Phone (703) 269-9866

5809 Leesburg Pike
Falls Church, VA 22041
Phone (866) 693-9336

7367 Atlas Walk Way
Gainesville, VA 20155
Phone (703) 753-7200

617 Potomac Station Dr NE
#A
Leesburg, VA 20176
Phone (703) 669-4646

9930 Sowder Village Sq
Ste 220
Manassas, VA 20109
Phone (703) 368-2121

9675 Liberia Ave
Ste 108
Manassas, VA 20110
Phone (703) 331-2122

1841 Fountain Dr
Reston, VA 20190
Phone (703) 264-2020

22000 Dulles Retail Plz
Ste 168
Sterling, VA 20166
Phone (703) 421-3322

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

401 Maple Ave W
Vienna, VA 22180
Phone (703) 938-5544

1950 Old Gallows Rd
Ste 100
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

14465 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 494-6184

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1023190030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 EAST WEST HIGHWAY",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20814",
            "telephone_number": "301-656-0775",
            "fax_number": "301-656-5164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATCHUK",
        "first_name": "GREGORY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001165",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA-1679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.