Individual provider Active NPI

Myron Wasiuta, O.D.

  • Optometrist
  • Culpeper, VA
National Provider Identifier
1245219203
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000246 Issued in VA
Practice address
15189 Montanus Dr
Culpeper, VA 22701-1679
Phone
(540) 825-8220
Fax
(540) 825-8675
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000246 VA Primary

Addresses

Primary practice location

15189 Montanus Dr
Culpeper, VA 22701-1679

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

15189 Montanus Dr
Culpeper, VA 22701-1679
Phone (540) 825-8220

Other identifiers 1

IdentifierTypeStateIssuer
9236066MedicaidVA

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
I20050726001027 VA Practitioner - Optometry 2062449523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Alabama School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Virginia, PLLCGroup PAC ID 0143448456, 133 clinicians

Practice addresses (Care Compare)

15189 Montanus Dr
Culpeper, VA 22701-1679
Phone (540) 825-8220

44727 Brimfield Dr
Ashburn, VA 20147-5920
Phone (571) 385-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000246VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Virginia PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Oct 3, 2016 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Oct 3, 2016 Accepting new patients
Access Eye Centers, Inc. Optometrist Past Accepting new patients

Locations

44727 Brimfield Dr
Ashburn, VA 20147
Phone (571) 385-4600

15189 Montanus Dr
Culpeper, VA 22701
Phone (540) 825-8220

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 4

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": "1516838400000",
    "number": "1245219203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "866-795-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15189 MONTANUS DR",
            "city": "CULPEPER",
            "state": "VA",
            "postal_code": "227011679",
            "telephone_number": "540-825-8220",
            "fax_number": "540-825-8675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15189 Montanus Dr",
            "address_purpose": "LOCATION",
            "city": "Culpeper",
            "state": "VA",
            "postal_code": "227011679",
            "country_code": "US",
            "telephone_number": "540-825-8220",
            "fax_number": "540-825-8675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASIUTA",
        "first_name": "MYRON",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9236066",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Culpeper, VA

Sources for this page

Verify at the official NPI Registry.