Individual provider Active NPI

Robert Michael Resnick, OD

  • Optometrist
  • Virginia Beach, VA
National Provider Identifier
1073698270
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000513 Issued in VA
Practice address
1255 Fordham Dr
Virginia Beach, VA 23464-5347
Phone
(757) 523-0161
Fax
(757) 523-0289
NPI assigned
Oct 26, 2006
Last updated
Jan 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000513 VA Primary

Addresses

Primary practice location

1255 Fordham Dr
Virginia Beach, VA 23464-5347

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (709) 847-8899

Other practice location 1

1401 Greenbrier Pkwy
Ste 1156
Chesapeake, VA 23320
Phone (757) 523-2000

Other identifiers 1

IdentifierTypeStateIssuer
010201772MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000513VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Virginia PLLC Optometrist Current Accepting new patients
National Optometry Steven Kasinof and 17 Associates Optometrists Optometrist Past Accepting new patients
Privia Medical Group, LLC Past Accepting new patients

Locations

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

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1255 Fordham Dr
Ste 114
Virginia Beach, VA 23464
Phone (757) 523-0161

Organizations & group practices 3

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1073698270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "709-847-8899",
            "fax_number": "866-795-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 FORDHAM DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234645347",
            "telephone_number": "757-523-0161",
            "fax_number": "757-523-0289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Greenbrier Pkwy",
            "address_2": "Ste 1156",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "23320",
            "country_code": "US",
            "telephone_number": "757-523-2000",
            "fax_number": "757-523-2003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RESNICK",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010201772",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.