Individual provider Active NPI

Negin Azhandeh, O.D.

  • Optometrist
  • Chantilly, VA
National Provider Identifier
1073403440
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618003541 Issued in VA
Practice address
25055 Riding PLZ Ste 100
Chantilly, VA 20152-5918
Phone
(703) 957-3384
Fax
(703) 957-3387
NPI assigned
Jul 8, 2025
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618003541 VA Primary
Occupational Vision Optometrist 152WX0102X 0618003541 VA

Addresses

Primary practice location

25055 Riding PLZ Ste 100
Chantilly, VA 20152-5918

Mailing address

25055 Riding PLZ Ste 100
Chantilly, VA 20152-5918
Phone (703) 957-3384

Other practice location 1

5511 Merchants View Sq
Haymarket, VA 20169-5439
Phone (703) 957-3384

Other practice location 2

21001 Sycolin Rd Ste 140
Ashburn, VA 20147-4074
Phone (703) 957-3384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0618003541VAMDOccupational Vision Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Consultants of Virginia, Inc Optometrist CurrentSince Jun 6, 2012 Accepting new patients

Locations

21001 Sycolin Rd
Ste 140
Ashburn, VA 20147
Phone (703) 722-8688

5511 Merchants View Sq
Haymarket, VA 20169
Phone (703) 659-4430

25055 Riding Plz
Ste 100
South Riding, VA 20152
Phone (703) 957-3384

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1073403440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25055 RIDING PLZ STE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201525918",
            "telephone_number": "703-957-3384",
            "fax_number": "703-957-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25055 RIDING PLZ STE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201525918",
            "telephone_number": "703-957-3384",
            "fax_number": "703-957-3387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5511 Merchants View Sq",
            "address_purpose": "LOCATION",
            "city": "Haymarket",
            "state": "VA",
            "postal_code": "201695439",
            "country_code": "US",
            "telephone_number": "703-957-3384",
            "fax_number": "703-957-3387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21001 Sycolin Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Ashburn",
            "state": "VA",
            "postal_code": "201474074",
            "country_code": "US",
            "telephone_number": "703-957-3384",
            "fax_number": "703-957-3387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZHANDEH",
        "first_name": "NEGIN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618003541",
            "primary": true
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "VA",
            "license": "0618003541",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.