Individual provider Active NPI

Mark K. Meadows, O.D.

  • Optometrist
  • Hayes, VA
National Provider Identifier
1104812536
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
#0601800484 Issued in VA
Practice address
3449 George Washington Memorial Hwy
Hayes, VA 23072-3100
Phone
(804) 642-2290
Fax
(804) 684-2166
NPI assigned
Sep 21, 2005
Last updated
May 21, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X #0601800484 VA Primary

Addresses

Primary practice location

3449 George Washington Memorial Hwy
Hayes, VA 23072-3100

Mailing address

3449 George Washington Memorial Hwy
Hayes, VA 23072-3100
Phone (804) 642-2290

Other identifiers 1

IdentifierTypeStateIssuer
010026911MedicaidVA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051109000835 VA Practitioner - Optometry 8628096435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Eye Associates, Inc. OptometristsGroup PAC ID 7911043021, 4 clinicians

Practice addresses (Care Compare)

3449 George Washington Memorial
Hayes, VA 23072-3100
Phone (804) 642-2290

3449 George Washington Memorial Hwy
Hayes, VA 23072-3100

Merit-based Incentive Payment System (MIPS)

Final score
10 of 100Reported as individual
Quality
20
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
#0601800484VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Eye Associates, Inc. Optometrists Optometrist CurrentSince Aug 15, 2003 Accepting new patients

Locations

3449 George Washington Memorial Hwy
Hayes, VA 23072
Phone (804) 642-2290

1322 Jamestown Rd
Williamsburg, VA 23185

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1104812536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3449 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "HAYES",
            "state": "VA",
            "postal_code": "230723100",
            "telephone_number": "804-642-2290",
            "fax_number": "804-684-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3449 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "HAYES",
            "state": "VA",
            "postal_code": "230723100",
            "telephone_number": "804-642-2290",
            "fax_number": "804-684-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEADOWS",
        "first_name": "MARK",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "#0601800484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010026911",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayes, VA

Sources for this page

Verify at the official NPI Registry.