NPIMap

Organization Active NPI

Glaucoma Consultants of Washington, Inc.

  • Ophthalmology Physician
  • Herndon, VA
National Provider Identifier
1073782777
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101052835 Issued in VA
Legal business name
GLAUCOMA CONSULTANTS OF WASHINGTON, INC.
Practice address
171 Elden St
Suite 100
Herndon, VA 20170-4875
Phone
(703) 689-2020
Fax
(703) 563-3769
NPI assigned
Feb 27, 2008
Last updated
Mar 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Authorized official

Name
Dr. Sameer Imtiaz Ahmad, M.D.NPI 1326003401
Title
Director
Phone
(703) 689-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0101052835 VA Primary

Addresses

Primary practice location

171 Elden St
Suite 100
Herndon, VA 20170-4875

Mailing address

PO Box 651091
Sterling, VA 20165-1091
Phone (703) 689-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090414000324 VA Part B Supplier - Clinic/Group Practice 1153497821 Receives reassigned benefits from 6 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winchester, VA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Glaucoma Consultants of Washington5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1073782777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 651091",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201651091",
            "telephone_number": "703-689-2020",
            "fax_number": "703-563-3769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ELDEN ST",
            "address_2": "SUITE 100",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704875",
            "telephone_number": "703-689-2020",
            "fax_number": "703-563-3769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLAUCOMA CONSULTANTS OF WASHINGTON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "SAMEER",
        "authorized_official_middle_name": "IMTIAZ",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-689-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101052835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.