Individual provider Active NPI

Jen Fang Liu Weigel, O.D.

  • Optometrist
  • MC Lean, VA
National Provider Identifier
1184603003
Registry record updated Sep 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001547 Issued in VA
Practice address
7930 Jones Branch Dr
Suite 250
MC Lean, VA 22102-3388
Phone
(703) 556-9155
NPI assigned
Jan 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001547 VA Primary

Addresses

Primary practice location

7930 Jones Branch Dr
Suite 250
MC Lean, VA 22102-3388

Mailing address

7930 Jones Branch Dr
Suite 250
MC Lean, VA 22102-3388
Phone (703) 556-9155

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210623000021 DC Practitioner - Optometry 3870520448 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Eyecare Center, P.C. Optometrist CurrentSince Oct 1, 2021 Accepting new patients
Associates in Eyecare Stone Ridge PC Optometrist Past Accepting new patients
Optometric Associates, P. C. Optometrist PastSince Mar 5, 1992 Accepting new patients

Locations

9314 Old Keene Mill Rd
Ste A
Burke, VA 22015
Phone (703) 569-3131

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315180800000",
    "number": "1184603003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7930 JONES BRANCH DR",
            "address_2": "SUITE 250",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023388",
            "telephone_number": "703-556-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7930 JONES BRANCH DR",
            "address_2": "SUITE 250",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023388",
            "telephone_number": "703-556-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIGEL",
        "first_name": "JEN",
        "middle_name": "FANG LIU",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2011-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

Verify at the official NPI Registry.