Individual provider Active NPI

Bruce A Kiraly, O.D.

  • Optometrist
  • Midlothian, VA
National Provider Identifier
1104906387
Registry record updated May 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000178 Issued in VA
Practice address
14431 Sommerville CT
Ste B
Midlothian, VA 23113-6812
Phone
(804) 888-8998
Fax
(804) 888-8999
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000178 VA Primary

Addresses

Primary practice location

14431 Sommerville CT
Ste B
Midlothian, VA 23113-6812

Mailing address

3601 Grove Ave
Richmond, VA 23221-2201
Phone (804) 358-8443

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
I20120501000446 VA Practitioner - Optometry 0345370292 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000178VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Grove Ave Eye Center PC Optometrist CurrentSince Feb 6, 1995 Accepting new patients
Jenny Alsop, OD PLLC Optometrist Past Accepting new patients

Locations

14431 Sommerville Ct
Ste B
Midlothian, VA 23113
Phone (804) 358-8443

3601 Grove Ave
Richmond, VA 23221
Phone (804) 353-3937

Organizations & group practices 2

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495670400000",
    "number": "1104906387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 GROVE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232212201",
            "telephone_number": "804-358-8443",
            "fax_number": "804-358-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14431 SOMMERVILLE CT",
            "address_2": "STE B",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231136812",
            "telephone_number": "804-888-8998",
            "fax_number": "804-888-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRALY",
        "first_name": "BRUCE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2017-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.