Peyam Mojallal, OD

Primary specialty

Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X

License

0618001051 Issued in VA

Practice address

20600 Gordon Park SQ
Suite 150
Ashburn, VA 20147-3145

Phone

(703) 723-3433

Fax

(703) 723-1920

NPI assigned

May 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

State University of New York - State College Optometry, 2000

Medicare assignment

May accept Medicare assignment

Group practices

Acuity Vision Care PCGroup PAC ID 0547469710, 2 clinicians

Prevention of Blindness Society of Metropolitan Washington IncGroup PAC ID 6406353341, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AEEFDD/Endpoint/AEEFDD

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.

• Acuity Vision Care PC

  • Optometrist
  • Ashburn, VA
  • NPI 1871634675

  VA

  Medicare reassignment Care Compare group Authorized official
• Peyam Mojallal OD and Associates

  • Optometrist
  • Ashburn, VA
  • NPI 1679615009

  DC, Optometrist, VA

  Medicare reassignment NPD Authorized official
• Prevention of Blindness Society of Metropolitan Washington Inc

  • Optometrist
  • Washington, DC
  • NPI 1487402970

  DC, Optometrist

  Medicare reassignment Care Compare group NPD
• Acuity Eye Fitness

  • Vision Therapy Optometrist
  • Ashburn, VA
  • NPI 1972229524
  NPD
• Prevention of Blindness Society of Metropolitan Washington Inc

  • Optometrist
  • Alexandria, VA
  • NPI 1790661312
  NPD
• Daniel Poth, O.D. and Associates, P.C.

  • Eyewear Supplier
  • Alexandria, VA
  • NPI 1063454460

  Optometrist

  NPD (past)
• Tewodros Gedamu, O.D. & Associates, LLC

  • Optometrist
  • Fairfax, VA
  • NPI 1114101425
  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1154378511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20600 GORDON PARK SQ",
            "address_2": "SUITE 150",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201473145",
            "telephone_number": "703-723-3433",
            "fax_number": "703-723-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20600 GORDON PARK SQ",
            "address_2": "SUITE 150",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201473145",
            "telephone_number": "703-723-3433",
            "fax_number": "703-723-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJALLAL",
        "first_name": "PEYAM",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001051",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "VA",
            "license": "0618001051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9236805",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhyan A Mitchell, LRC
• John Michael Mitchelson, PT, DPT
• Mna Innovations LLC
• Courtney Amber Moats, M.D.
• Anousheh Mohandes Tarighi, MSN, APRN, FNP-BC
• Lina Mojarrad, OD
• Stephanie Moniz
• Elizabeth Michelle Moody, ED.S.
• Laura Moon
• Cary Craig Moorman, LPC

• Low Vision Rehabilitation Optometrist in Ashburn, VA
• Providers in Ashburn, VA by specialty
• Low Vision Rehabilitation Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.