Individual provider Active NPI

Kristen Montgomery, O.D.

  • Optometrist
  • Germantown, MD
National Provider Identifier
1083979173
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002131 Issued in VA
Practice address
19814 Century Blvd
Germantown, MD 20874-1198
Phone
(301) 540-1200
Fax
(301) 528-9746
NPI assigned
Jul 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2306 MD
Optometrist 152W00000X 0618002131 VA Primary

Addresses

Primary practice location

19814 Century Blvd
Germantown, MD 20874-1198

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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

Enrollment IDStateProvider typePAC IDDetails
I20121120000098 DC Practitioner - Optometry 9234380312 Reassigns benefits to 3 organizations
I20121218000215 VA Practitioner - Optometry 9234380312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Maryland LLCGroup PAC ID 6002037629, 121 clinicians

Practice addresses (Care Compare)

19814 Century Blvd
Germantown, MD 20874-1198
Phone (301) 540-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618002131VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Nov 12, 2019 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Virginia PLLC Optometrist CurrentSince Nov 22, 2017 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Nov 22, 2017 Accepting new patients
Myeyedr Optometry of Maryland, LLC Optometrist CurrentSince Sep 30, 2015 Accepting new patients
Rockville Optometry, LLC Optometrist CurrentSince Oct 30, 2018 Accepting new patients
Dulles Optometry, LLC Optometrist CurrentSince Nov 22, 2017 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist Current Accepting new patients
Ballston Optometry, LLC Optometrist Past Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients

Locations

19814 Century Blvd
Germantown, MD 20874
Phone (301) 540-1200

1701 Rockville Pike
Ste A4
Rockville, MD 20852
Phone (301) 984-2111

14929 Shady Grove Rd
Unit K
Rockville, MD 20850
Phone (301) 424-1050

44727 Brimfield Dr
Ashburn, VA 20147
Phone (571) 385-4600

7511 Leesburg Pike
Ste 101B
Falls Church, VA 22043
Phone (703) 942-5300

5809 Leesburg Pike
Falls Church, VA 22041
Phone (866) 693-9336

1841 Fountain Dr
Reston, VA 20190
Phone (703) 264-2020

22000 Dulles Retail Plz
Ste 168
Sterling, VA 20166
Phone (703) 421-3322

1950 Old Gallows Rd
Ste 100
Vienna, VA 22182

401 Maple Ave W
Vienna, VA 22180
Phone (703) 938-5544

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 10

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": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1083979173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "866-795-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19814 CENTURY BLVD",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741198",
            "telephone_number": "301-540-1200",
            "fax_number": "301-528-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "KRISTEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2306",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.