NPIMap

Organization Active NPI

Eye Specialists and Surgeons of Northern Virginia, LLC

  • Ophthalmology Physician
  • Fairfax, VA
National Provider Identifier
1275904674
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE SPECIALISTS AND SURGEONS OF NORTHERN VIRGINIA, LLC
Practice address
3998 Fair Ridge Dr Ste 105
Fairfax, VA 22033-2980
Phone
(571) 349-2191
Fax
(571) 349-2211
NPI assigned
Oct 12, 2015
Last updated
Dec 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Authorized official

Name
John Josephson, MDNPI 1154588374
Title
Owner
Phone
(201) 417-8238

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

3998 Fair Ridge Dr Ste 105
Fairfax, VA 22033-2980

Mailing address

4000 Legato Rd
Suite 1100
Fairfax, VA 22033-2892
Phone (201) 417-8238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151214000649 DC Part B Supplier - Clinic/Group Practice 1658672886 Receives reassigned benefits from 13 practitioners
Practice locations: Falls Church, VA; Great Falls, VA; Gainesville, VA; Fairfax, VA
O20160812000325 VA Part B Supplier - Clinic/Group Practice 1658672886 Receives reassigned benefits from 9 practitioners
Practice locations: Aldie, VA; Gainesville, VA; Manassas, VA; Purcellville, VA

National Provider Directory

National Provider Directory

Locations

11200 Rockville Pike
Ste 150
Rockville, MD 20852
Phone (301) 881-2020

3998 Fair Ridge Dr
Ste 105
Fairfax, VA 22033
Phone (571) 349-2191

3998 Fair Ridge Dr
Ste 110
Fairfax, VA 22033

3998 Fair Ridge Dr
Ste 150
Fairfax, VA 22033

7915 Lake Manassas Dr
Ste 210
Gainesville, VA 20155
Phone (571) 349-2191

1201 Wolf Rock Dr
Purcellville, VA 20132
Phone (540) 441-3719

Interoperability endpoints

  • Direct secure messaging: eong@essnv.intellechartdirect.net
  • Direct secure messaging: hpham@essnv.intellechartdirect.net
  • Direct secure messaging: hstark@essnv.intellechartdirect.net
  • Direct secure messaging: jjosephson@essnv.intellechartdirect.net
  • Direct secure messaging: jpierce@essnv.intellechartdirect.net
  • Direct secure messaging: kdunbar@essnv.intellechartdirect.net
  • Direct secure messaging: lmojarrad@essnv.intellechartdirect.net
  • Direct secure messaging: mmoroux@essnv.intellechartdirect.net
  • Direct secure messaging: nsahraei@essnv.intellechartdirect.net
  • Direct secure messaging: pmodak@essnv.intellechartdirect.net
  • Direct secure messaging: sittoop@essnv.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544400000000",
    "number": "1275904674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 LEGATO RD",
            "address_2": "SUITE 1100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332892",
            "telephone_number": "201-417-8238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DR STE 105",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332980",
            "telephone_number": "571-349-2191",
            "fax_number": "571-349-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SPECIALISTS AND SURGEONS OF NORTHERN VIRGINIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-12",
        "last_updated": "2018-12-10",
        "status": "A",
        "authorized_official_last_name": "JOSEPHSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-417-8238",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.