Alexandria Ophthalmic Associates, P.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0101041044 Issued in VA

Legal business name

ALEXANDRIA OPHTHALMIC ASSOCIATES, P.C.

Practice address

411 N Washington St
Alexandria, VA 22314-2311

Phone

(703) 548-5588

Fax

(703) 549-1599

NPI assigned

Mar 16, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jacob A Clark, M.D.NPI 1164464806

Title

President/Owner

Phone

(703) 548-5588

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/clark

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacob A Clark, MD

  • Ophthalmology Physician
  • Alexandria, VA
  • NPI 1164464806

  DC

  Medicare reassignment NPD Authorized official
• Jacob Scott Clark, D.C.

  • Chiropractor
  • Lafayette, LA
  • NPI 1003864620
  NPD (past)

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

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1285958538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N WASHINGTON ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142311",
            "telephone_number": "703-548-5588",
            "fax_number": "703-549-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N WASHINGTON ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142311",
            "telephone_number": "703-548-5588",
            "fax_number": "703-549-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDRIA OPHTHALMIC ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-16",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "703-548-5588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101041044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6375570",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180015264",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandria Mental Health
• Alexandria Midwife
• Alexandria Neighborhood Health Services, Inc.
• Alexandria Old Town Dental PLLC
• Alexandria Operator LLC
• Alexandria Optimum Health LLC
• Alexandria Optometry, PLLC
• Alexandria Oral Surgery, PLLC
• Alexandria Pain & Rehabilitation Center,LLC
• Alexandria Pathology Associates, P.C.

• Ophthalmology Physician in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Ophthalmology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; 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.