Individual provider Active NPI

David Pan, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Harrisonburg, VA
National Provider Identifier
1083854699
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
0101247898 Issued in VA
Practice address
1880 Reservoir St Ste a
Harrisonburg, VA 22801-8832
Phone
(540) 920-2020
Fax
(540) 920-0828
NPI assigned
Feb 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Retina Specialist (Ophthalmology) Physician 207WX0107X 0101247898 VA Primary

Addresses

Primary practice location

1880 Reservoir St Ste a
Harrisonburg, VA 22801-8832

Mailing address

1880 Reservoir St Ste a
Harrisonburg, VA 22801-8832
Phone (540) 920-2020

Other identifiers 1

IdentifierTypeStateIssuer
47062669813MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230515003316 VA Practitioner - Ophthalmology 1456545441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Drexel University College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1880 Reservoir St
Suite a
Harrisonburg, VA 22801-8832
Phone (540) 920-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101247898VAMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Wellness and Surgery PLLC Retina Specialist CurrentSince Oct 25, 2022 Accepting new patients
Peter Lou, M.D. P.C. Ophthalmology Past Accepting new patients
Edward a Ryan, MD, PC Ophthalmology PastSince Aug 22, 2012 Accepting new patients
Arnold J. Kroll,M.D.,P.C. Past Accepting new patients
Lahey Clinic, Inc. Past Accepting new patients
Sutton Skin and Eye Clinic PC PastSince Jul 24, 2022 Accepting new patients

Locations

1880 Reservoir St
Ste A
Harrisonburg, VA 22801
Phone (540) 434-3668

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1083854699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 RESERVOIR ST STE A",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228018832",
            "telephone_number": "540-920-2020",
            "fax_number": "540-920-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 RESERVOIR ST STE A",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228018832",
            "telephone_number": "540-920-2020",
            "fax_number": "540-920-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-23",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "VA",
            "license": "0101247898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47062669813",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

Verify at the official NPI Registry.