Jacqueline E Pokusa, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG003023 Issued in PA

Practice address

6677 Richmond Hwy
Alexandria, VA 22306-6647

Phone

(703) 535-5568

NPI assigned

Oct 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacqueline.pokusa@nhnva.eclinicaldirectplus.com

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.

• Neighborhood Health

  • Federally Qualified Health Center (FQHC)
  • Alexandria, VA
  • NPI 1154674026

  DC

  Medicare reassignment NPD
• Steer Optical LLC

  • Medical Specialty Clinic/Center
  • Arlington, VA
  • NPI 1023353638

  DC

  Medicare reassignment NPD
• Children'S Hospital

  • Children's Hospital
  • Washington, DC
  • NPI 1912939703
  Medicare reassignment NPD
• Neighborhood Health

  • Federally Qualified Health Center (FQHC)
  • Alexandria, VA
  • NPI 1215259775
  NPD
• Neighborhood Health

  • Federally Qualified Health Center (FQHC)
  • Arlington, VA
  • NPI 1225899719

  Pediatrics

  NPD
• Children'S Hospital

  • Community/Retail Pharmacy
  • Silver Spring, MD
  • NPI 1326878349
  NPD
• Children'S Hospital

  • Pediatrics Physician
  • Washington, DC
  • NPI 1780800128
  NPD
• Neighborhood Health

  • Federally Qualified Health Center (FQHC)
  • Alexandria, VA
  • NPI 1164620027
  NPD (past)

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1104178094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6677 RICHMOND HWY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223066647",
            "telephone_number": "703-535-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6677 RICHMOND HWY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223066647",
            "telephone_number": "703-535-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POKUSA",
        "first_name": "JACQUELINE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MA",
            "license": "4941",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MD",
            "license": "TA2382",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "VA",
            "license": "0618002276",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "DC",
            "license": "OP1000276",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE NUMBER",
            "identifier": "OEG003023",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF EXAMINERS IN OPTOMETRY, LICENSE NUMBER",
            "identifier": "TA2382",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSACHUSETTS BOARD OF OPTOMETRY, LICENSE NUMBER",
            "identifier": "4941",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF OPTOMETRY, LICENSE NUMBER",
            "identifier": "OP1000276",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF OPTOMETRY, LICENSE NUMBER",
            "identifier": "0618002276",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eve Margaret Poetzschke, CNM, WHNP-BC
• Leah Poggi, PTA
• Geraldine B Pogue, LCSW
• Steve Poku-Kwateng, RPH
• Natalie Poku
• Frances S Poleto, LMHC
• Vincent Anthony Policelli, M.D.
• Sabrina Marie Malak Polio, LCSW
• Elizabeth Lein Polis, PT, DPT
• Alan J Pollack, MD

• Optometrist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.