Alex Dertad Manguikian, M.D., PH.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0101253390 Issued in VA

Practice address

9936 Main St
Fairfax, VA 22031-3901

Phone

(703) 591-4884

NPI assigned

May 18, 2009

Last updated

Mar 19, 2013By the provider in NPPES

Sex

Male

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 DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

George Washington University School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

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.

• Fairfax Eye Associates Inc

  • Ophthalmology Physician
  • Fairfax, VA
  • NPI 1881663102

  DC

  Medicare reassignment
• Anh Nguyen, M.D., P.C.

  • Ophthalmology Physician
  • Falls Church, VA
  • NPI 1215962840
  NPD (past)
• John P Essepian MD PC

  • Ophthalmology Physician
  • Fairfax, VA
  • NPI 1902085376
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Inova Health Care Services

  dba Inova Fairfax Hospital

  • Rehabilitation Hospital Unit
  • Falls Church, VA
  • NPI 1588795462
  Care Compare affiliation
• Inova Health Care Services

  dba Inova Fairfax Hospital

  • General Acute Care Hospital
  • Falls Church, VA
  • NPI 1831220714
  Care Compare affiliation

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363651200000",
    "number": "1164657342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9936 MAIN ST",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313901",
            "telephone_number": "703-591-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9936 MAIN ST",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313901",
            "telephone_number": "703-591-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUIKIAN",
        "first_name": "ALEX",
        "middle_name": "DERTAD",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-18",
        "last_updated": "2013-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101253390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manestream Consulting LLC (Bravadas)
• Chaitanya Surendra Mangalmurti, MD
• Lauren Manganello, MS, RD, LDN
• Vikas Mangewala, M.D.
• Wien Manguerra-Casiano, D.O.
• Kanan D Maniar, M.D.
• Timothy Patrick Manley, M.S.W.
• Lauryn Mann
• Susan E Mannan, M.D.
• Laura Jean Manning, MA, CCC-SLP

• Ophthalmology Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Ophthalmology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; 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.