DMV Vision Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TA2470 Issued in MD

Legal business name

DMV VISION CARE, LLC

Practice address

3134 Crain Hwy
Waldorf, MD 20603-4846

Phone

(301) 374-9615

NPI assigned

Feb 5, 2018

Last updated

Feb 5, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shahab Motamedi, ODNPI 1083095863

Title

Optometrist

Phone

(301) 374-9615

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

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.

• Shahab Motamedi, O.D.

  • Optometrist
  • Waldorf, MD
  • NPI 1083095863
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517788800000",
    "number": "1083113179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3048 SUGAR LN",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221816061",
            "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": "301-374-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMV VISION CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-05",
        "last_updated": "2018-02-05",
        "status": "A",
        "authorized_official_last_name": "MOTAMEDI",
        "authorized_official_first_name": "SHAHAB",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "301-374-9615",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Feb 5, 2018; 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.