Eyelid & Oculoplastic Consultants, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101052465 Issued in VA

Legal business name

EYELID & OCULOPLASTIC CONSULTANTS, PC

Doing business as

The Face Institute

Practice address

1821 Old Donation Pkwy
Suite 6
Virginia Beach, VA 23454-3033

Phone

(757) 496-4864

Fax

(757) 496-4942

NPI assigned

May 10, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Matthew James Mitsch, M.D.

Title

President

Phone

(757) 496-4864

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Face Institute Doing business as

Locations

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154535623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 OLD DONATION PKWY",
            "address_2": "SUITE 6",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543033",
            "telephone_number": "757-496-4864",
            "fax_number": "757-496-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 OLD DONATION PKWY",
            "address_2": "SUITE 6",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543033",
            "telephone_number": "757-496-4864",
            "fax_number": "757-496-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYELID & OCULOPLASTIC CONSULTANTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITSCH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-496-4864",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101052465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6900925",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Face Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.