Individual provider Active NPI

Kiera Ann Hagan, OD

  • Optometrist
  • Fredericksburg, VA
National Provider Identifier
1144894452
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618003381 Issued in VA
Practice address
4710 Spotsylvania Pkwy
Fredericksburg, VA 22407-9433
Phone
(540) 741-2733
NPI assigned
May 20, 2021
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618003381 VA Primary

Addresses

Primary practice location

4710 Spotsylvania Pkwy
Fredericksburg, VA 22407-9433

Mailing address

4371 Palton Dr
Dumfries, VA 22025-2031
Phone (954) 940-1999

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
I20240924003060 VA Practitioner - Optometry 5294118634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Washington Eye Care Center, LLCGroup PAC ID 9931238094, 6 clinicians

Practice addresses (Care Compare)

4710 Spotsylvania Pkwy
Suite 104
Fredericksburg, VA 22407-9433
Phone (540) 741-2733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618003381VAMDOptometrist
3242CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Washington Eye Care Center, LLC Optometrist CurrentSince Nov 4, 2024 Accepting new patients

Locations

4710 Spotsylvania Pkwy
Fredericksburg, VA 22407
Phone (540) 373-7133

4710 Spotsylvania Pkwy
Ste 104
Fredericksburg, VA 22407
Phone (540) 741-2733

Interoperability endpoints

  • Direct secure messaging: khagan126806@marywashingtonhealthcare.direct-ci.com

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": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1144894452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 PALTON DR",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220252031",
            "telephone_number": "954-940-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 SPOTSYLVANIA PKWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224079433",
            "telephone_number": "540-741-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "KIERA",
        "middle_name": "ANN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618003381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.