Organization Active NPI

Eye Consultants & Surgeons, P.C.

  • Ophthalmology Physician
  • Arlington, VA
National Provider Identifier
1104158732
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0719012-7 Issued in VA
Legal business name
EYE CONSULTANTS & SURGEONS, P.C.
Practice address
611 S Carlin Springs Rd
Suite 208
Arlington, VA 22204
Phone
(703) 639-4455
Fax
(703) 462-8331
NPI assigned
Feb 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Walter Qiang Wang, M.D.NPI 1578544862
Title
Director
Phone
(703) 639-4455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 0719012-7 VA Primary

Addresses

Primary practice location

611 S Carlin Springs Rd
Suite 208
Arlington, VA 22204

Mailing address

611 S Carlin Springs Rd
Suite 208
Arlington, VA 22204
Phone (703) 639-4455

Other names 1

  • Eye Consultants & Surgeons Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101011000302 DC Part B Supplier - Clinic/Group Practice 4284826140 Receives reassigned benefits from 1 practitioner
Practice locations: Arlington, VA
O20110812000426 MD Part B Supplier - Clinic/Group Practice 4284826140 Receives reassigned benefits from 1 practitioner
Practice locations: Leonardtown, MD

National Provider Directory

National Provider Directory

Locations

611 S Carlin Springs Rd
Ste 208
Arlington, VA 22204
Phone (703) 639-4455

1830 Town Center Dr
Ste 210
Reston, VA 20190
Phone (571) 323-0980

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1104158732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 S CARLIN SPRINGS RD",
            "address_2": "SUITE 208",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "22204",
            "telephone_number": "703-639-4455",
            "fax_number": "703-931-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S CARLIN SPRINGS RD",
            "address_2": "SUITE 208",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "22204",
            "telephone_number": "703-639-4455",
            "fax_number": "703-462-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CONSULTANTS & SURGEONS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-07",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "QIANG",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-639-4455",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0719012-7",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Consultants & Surgeons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.