Individual provider Active NPI

Marjan Keramati, OD

  • Optometrist
  • Vienna, VA
National Provider Identifier
1073695086
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0601002207 Issued in VA
Practice address
8359 Leesburg Pike
Vienna, VA 22182-2492
Phone
(703) 442-9295
Fax
(703) 749-0936
NPI assigned
Oct 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0601002207 VA Primary

Addresses

Primary practice location

8359 Leesburg Pike
Vienna, VA 22182-2492

Mailing address

11103 West Ave
Suite 6
San Antonio, TX 78213-1370
Phone (210) 524-6509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20250606000557 DC Practitioner - Optometry 8921518218 Reassigns benefits to 1 organization
I20250606000694 MD Practitioner - Optometry 8921518218 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0601002207VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc. Optometrist Current Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Apr 4, 2025 Accepting new patients
Visionworks, Inc. Optometrist Current Accepting new patients
Visionworks, Inc CurrentSince Apr 4, 2025 Accepting new patients
Visionworks Inc. Past Accepting new patients

Locations

4301 Wisconsin Ave NW
Washington, DC 20016
Phone (202) 237-8500

169 Jennifer Rd
Ste D
Annapolis, MD 21401
Phone (410) 224-0021

15431 Emerald Way
Bowie, MD 20716
Phone (301) 805-6132

23415 Three Notch Rd
Ste 1101
California, MD 20619
Phone (301) 862-1896

10112 York Rd
Cockeysville, MD 21030
Phone (410) 628-5350

Organizations & group practices 5

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073695086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "SUITE 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6509",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8359 LEESBURG PIKE",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822492",
            "telephone_number": "703-442-9295",
            "fax_number": "703-749-0936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERAMATI",
        "first_name": "MARJAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601002207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vienna, VA

Sources for this page

Verify at the official NPI Registry.