Shahab Motamedi, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002425 Issued in VA

Practice address

3134 Crain Hwy
Waldorf, MD 20603-4846

Phone

(610) 349-6810

NPI assigned

Jun 17, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 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

Specialty

Optometry

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• DMV Vision Care, LLC

  • Optometrist
  • Waldorf, MD
  • NPI 1083113179
  Medicare reassignment NPD Authorized official
• Luxottica of America Inc

  • Eyewear Supplier
  • Falls Church, VA
  • NPI 1376696005
  NPD (past)

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1083095863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3134 CRAIN HWY",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034846",
            "telephone_number": "610-349-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3134 CRAIN HWY",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034846",
            "telephone_number": "610-349-6810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 W Broad St Ste N",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220463362",
            "country_code": "US",
            "telephone_number": "703-241-0778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOTAMEDI",
        "first_name": "SHAHAB",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tommie Maria Morris
• Destiny Louanniah Morrison, DO
• Mia Mosby
• Nakiya Moss
• Mostafa PC
• Alexandra Mountford
• Mary Chinedu Mpi
• Kevin Mrohs, RPH
• Ms-HC, LLC
• Ms. & Mr. Little Ones, Inc.

• Optometrist in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.

Verify at the official NPI Registry.