Organization Active NPI

Riverside Physician Services Inc

Doing business as Hampton Roads Eye Associates-Williamsburg

  • Optometrist
  • Williamsburg, VA
National Provider Identifier
1083630545
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
RIVERSIDE PHYSICIAN SERVICES INC
Doing business as
Hampton Roads Eye Associates-Williamsburg
Practice address
120 Kings Way
Suite 1300
Williamsburg, VA 23185-2505
Phone
(757) 345-1001
Fax
(757) 345-3102
NPI assigned
Jul 15, 2006
Last updated
Oct 14, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
RIVERSIDE HEALTHCARE ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Authorized official

Name
James Lesnick, MDNPI 1467439919
Title
Vice President
Phone
(757) 594-4006

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary
Ophthalmology Physician 207W00000X NU

Addresses

Primary practice location

120 Kings Way
Suite 1300
Williamsburg, VA 23185-2505

Mailing address

120 Kings Way
Suite 1300
Williamsburg, VA 23185-2505
Phone (757) 345-3001

Other identifiers 1

IdentifierTypeStateIssuer
1083630545MedicaidVA

Other names 1

  • Hampton Roads Eye Associates-Williamsburg Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040207000400 VA Part B Supplier - Clinic/Group Practice 5092608448 Receives reassigned benefits from 1,191 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413244800000",
    "number": "1083630545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 KINGS WAY",
            "address_2": "SUITE 1300",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852505",
            "telephone_number": "757-345-3001",
            "fax_number": "757-345-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 KINGS WAY",
            "address_2": "SUITE 1300",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852505",
            "telephone_number": "757-345-1001",
            "fax_number": "757-345-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PHYSICIAN SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE HEALTHCARE ASSOCIATES",
        "enumeration_date": "2006-07-15",
        "last_updated": "2014-10-14",
        "status": "A",
        "authorized_official_last_name": "LESNICK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "757-594-4006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083630545",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hampton Roads Eye Associates-Williamsburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.