Individual provider Active NPI

Sylvia J Briceno, O.D.

  • Optometrist
  • South Riding, VA
National Provider Identifier
1285736454
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001881 Issued in VA
Practice address
25055 Riding PLZ Ste 100
South Riding, VA 20152-5918
Phone
(703) 961-9119
Fax
(703) 961-9230
NPI assigned
Sep 1, 2006
Last updated
Jan 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001881 VA Primary

Addresses

Primary practice location

25055 Riding PLZ Ste 100
South Riding, VA 20152-5918

Mailing address

25055 Riding PLZ Ste 100
South Riding, VA 20152-5918
Phone (703) 961-9119

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
I20170818001108 VA Practitioner - Optometry 7517984297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optometric Consultants of Virginia, IncGroup PAC ID 4082664792, 2 clinicians

Practice addresses (Care Compare)

25055 Riding PLZ
Suite 100
Chantilly, VA 20152-5918
Phone (703) 957-3384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618001881VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye and Vision Care Optometrist CurrentSince Feb 6, 2018 Accepting new patients
District Eyecare Inc Optometrist CurrentSince Feb 9, 2020 Accepting new patients
Kristen Banek PC Optometrist PastSince Sep 1, 2015 Accepting new patients
Brighton Eye Associates, P.C. Optometrist Past Accepting new patients
Northern Virginia Doctors of Optometry Optometrist Past Accepting new patients

Locations

4221 Walney Rd
Ste 100
Chantilly, VA 20151
Phone (703) 961-9119

3903 Fair Ridge Dr
Unit E
Fairfax, VA 22033
Phone (703) 961-9119

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1285736454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25055 RIDING PLZ STE 100",
            "city": "SOUTH RIDING",
            "state": "VA",
            "postal_code": "201525918",
            "telephone_number": "703-961-9119",
            "fax_number": "703-961-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25055 RIDING PLZ STE 100",
            "city": "SOUTH RIDING",
            "state": "VA",
            "postal_code": "201525918",
            "telephone_number": "703-961-9119",
            "fax_number": "703-961-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICENO",
        "first_name": "SYLVIA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Riding, VA

Sources for this page

Verify at the official NPI Registry.