Elisabeth Keunrok Kim, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001424 Issued in VA

Practice address

4565 Daisy Reid Ave Ste 108
Woodbridge, VA 22192-5671

Phone

(703) 878-8818

Fax

(703) 878-8819

NPI assigned

Feb 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 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

Pennsylvania College of Optometry, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Virginia, PLLCGroup PAC ID 0143448456, 133 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Myeyedr Optometry of Virginia PLLC

  • Optometrist
  • Ashburn, VA
  • NPI 1174933691
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • Falls Church, VA
  • NPI 1710343744

  DC

  Medicare reassignment NPD
• Total Vision Optometric Center, P.C.

  • Optometrist
  • Woodbridge, VA
  • NPI 1235311580
  NPD Authorized official
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • Arlington, VA
  • NPI 1548158603
  NPD
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • North Chesterfield, VA
  • NPI 1932075983
  NPD
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • Bristow, VA
  • NPI 1932865730
  NPD

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1154469070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 DAISY REID AVE STE 108",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925671",
            "telephone_number": "703-878-8818",
            "fax_number": "703-878-8819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4160 Merchant Plz",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221925085",
            "country_code": "US",
            "telephone_number": "703-878-8818",
            "fax_number": "703-878-8819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ELISABETH",
        "middle_name": "KEUNROK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crissy Kibic
• Kidz Dental, P.C.
• Douglas Kiessling, OD
• Maurice Randolph Kilgore, LCSWS
• Prajakta P Killekar, PT
• Grace Kim, M.A., QMHP-C, NCC
• Hee Don Kim, DDS
• Heeshin Kim, M.D.
• Hye Julie Kim
• Joo Han Kim, O.D.

• Optometrist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.