Active NPI
Peter Edwin Degraziano, O.D.
- Optometrist
- Fredericksburg, VA
National Provider Identifier
1184935009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0618001181
- Practice address
- 3102 Plank Rd Ste 600
Fredericksburg, VA 22407-4954 - Phone
- (540) 786-3405
- NPI assigned
- Jun 24, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 14132 | CA | |
| Optometrist | 152W00000X | 0618001181 | VA | Primary |
Addresses
Primary practice location
3102 Plank Rd Ste 600
Fredericksburg, VA 22407-4954
Mailing address
9200 Harvest Oak Dr
Fredericksburg, VA 22407-9214
Phone (540) 322-3813
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0618001181 | VA | MD | Optometrist |
| 14132 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372118400000",
"number": "1184935009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9200 HARVEST OAK DR",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224079214",
"telephone_number": "540-322-3813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3102 PLANK RD STE 600",
"city": "FREDERICKSBURG",
"state": "VA",
"postal_code": "224074954",
"telephone_number": "540-786-3405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGRAZIANO",
"first_name": "PETER",
"middle_name": "EDWIN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-24",
"last_updated": "2013-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "14132",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VA",
"license": "0618001181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.