Active NPI
Monica Park
- Optometrist
- Reston, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0618003425
- Practice address
- 11656 Plaza America Dr
Reston, VA 20190-4700 - Phone
- (703) 467-9080
- NPI assigned
- May 2, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0618003425 | VA | Primary |
Addresses
Primary practice location
11656 Plaza America Dr
Reston, VA 20190-4700
Mailing address
11656 Plaza America Dr
Reston, VA 20190-4700
Phone (703) 467-9080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- New England College of Optometry, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11656 Plaza America Dr
Reston, VA 20190-4700
Phone (703) 467-9080
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Virginia Doctors of Optometry | Optometrist | Current | Accepting new patients |
Locations
1632A Belle View Blvd
Alexandria, VA 22307
Phone (703) 660-9494
1632 Belle View Blvd
#A
Alexandria, VA 22307
7249 Arlington Blvd
Falls Church, VA 22042
Phone (703) 573-1200
11656 Plaza America Dr
Reston, VA 20190
Phone (703) 467-0359
Organizations & group practices 1
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": "1714608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726704000000",
"number": "1043067572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11656 PLAZA AMERICA DR",
"city": "RESTON",
"state": "VA",
"postal_code": "201904700",
"telephone_number": "703-467-9080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11656 PLAZA AMERICA DR",
"city": "RESTON",
"state": "VA",
"postal_code": "201904700",
"telephone_number": "703-467-9080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "MONICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-02",
"last_updated": "2024-09-19",
"certification_date": "2024-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VA",
"license": "0618003425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.