Individual provider Active NPI

David R Rose, O.D.

  • Corneal and Contact Management Optometrist
  • Manassas, VA
National Provider Identifier
1215154158
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
0618001451 Issued in VA
Practice address
8721 Digges Rd
Manassas, VA 20110-4403
Phone
(703) 361-4161
Fax
(703) 361-4163
NPI assigned
Apr 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 0618001451 VA Primary

Addresses

Primary practice location

8721 Digges Rd
Manassas, VA 20110-4403

Mailing address

1542A Heatherstone Dr
Fredericksburg, VA 22407-4849
Phone (614) 638-7673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20110523000151 VA Practitioner - Optometry 0941194500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optometric Associates, P. C.Group PAC ID 2769424399, 2 clinicians

Practice addresses (Care Compare)

8721 Digges Rd
Manassas, VA 20110-4403
Phone (703) 361-4161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618001451VAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Associates, P. C. Corneal and Contact Management CurrentSince Jan 17, 2016 Accepting new patients

Locations

8721 Digges Rd
Manassas, VA 20110
Phone (703) 361-4161

Organizations & group practices 1

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": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1215154158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542A HEATHERSTONE DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224074849",
            "telephone_number": "614-638-7673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8721 DIGGES RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104403",
            "telephone_number": "703-361-4161",
            "fax_number": "703-361-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "VA",
            "license": "0618001451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.