Individual provider Active NPI

Michael Gary Cohen, O.D.

  • Corneal and Contact Management Optometrist
  • Alexandria, VA
National Provider Identifier
1093711640
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
0618000156 Issued in VA
Practice address
4680 King St
Alexandria, VA 22302-1215
Phone
(703) 845-1404
Fax
(703) 845-5945
NPI assigned
Jun 27, 2005
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 0618000156 VA Primary
Low Vision Rehabilitation Optometrist 152WL0500X 0618000156 VA

Addresses

Primary practice location

4680 King St
Alexandria, VA 22302-1215

Mailing address

9814 Summerday Dr
Burke, VA 22015-4027
Phone (703) 425-6851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100928001466 DC Practitioner - Optometry 7214053180 Practice locations: Fairfax, VA; Alexandria, VA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000156VAMDLow Vision Rehabilitation Optometrist

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1093711640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9814 SUMMERDAY DR",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220154027",
            "telephone_number": "703-425-6851",
            "fax_number": "703-425-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4680 KING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223021215",
            "telephone_number": "703-845-1404",
            "fax_number": "703-845-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "MICHAEL",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "VA",
            "license": "0618000156",
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "VA",
            "license": "0618000156",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.