Active NPI
Tanya Sharma, OD
- Optometrist
- Fairfax, VA
National Provider Identifier
1144386608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0618001517
- Practice address
- 11784-L Lee Jackson Memorial Hwy
Fair Oaks Mall
Fairfax, VA 22033 - Phone
- (703) 591-9377
- NPI assigned
- Dec 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0618001517 | VA | Primary |
Addresses
Primary practice location
11784-L Lee Jackson Memorial Hwy
Fair Oaks Mall
Fairfax, VA 22033
Mailing address
11784-L Lee Jackson Mem. Hwy.
Fair Oaks Mall
Fairfax, VA 22033
Phone (703) 591-9377
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tewodros Gedamu, O.D. & Associates, LLC | Optometrist | Current | Accepting new patients |
Locations
3070 Bristol Pike
Ste 2-220
Bensalem, PA 19020
Phone 2144971001108
11784L Fair Oaks Mall
Fairfax, VA 22033
Phone (703) 591-9377
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 and National Provider Directory roles.
-
dba Dr. Tewodros Gedamu & Associates
- Optometrist
- Fairfax, VA
- NPI 1114101425
DC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461801600000",
"number": "1144386608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11784-L LEE JACKSON MEM. HWY.",
"address_2": "FAIR OAKS MALL",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "22033",
"telephone_number": "703-591-9377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11784-L LEE JACKSON MEMORIAL HWY",
"address_2": "FAIR OAKS MALL",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "22033",
"telephone_number": "703-591-9377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHARMA",
"first_name": "TANYA",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-29",
"last_updated": "2016-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VA",
"license": "0618001517",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.