Richard A. Jablonski, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

0618000066 Issued in VA

Practice address

12444 Dillingham SQ
Woodbridge, VA 22192-5258

Phone

(703) 680-4323

Fax

(703) 680-4358

NPI assigned

Apr 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Ridge Vision Center PLLCGroup PAC ID 8628144938, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Lake Ridge Vision Center PLLC

  • Optometrist
  • Woodbridge, VA
  • NPI 1285807404
  Medicare reassignment Care Compare group NPD Authorized official
• Lake Ridge Vision Center, Inc

  • Optometrist
  • Woodbridge, VA
  • NPI 1508953431

  Corneal and Contact Management

  NPD (past)

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

{
    "created_epoch": "1143849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1295796712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12444 DILLINGHAM SQ",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925258",
            "telephone_number": "703-680-4323",
            "fax_number": "703-680-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12444 DILLINGHAM SQ",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925258",
            "telephone_number": "703-680-4323",
            "fax_number": "703-680-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABLONSKI",
        "first_name": "RICHARD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-01",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "VA",
            "license": "0618000066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4461542",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "031112",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "54-1330725",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2129817",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHYCARE/OPT CH",
            "identifier": "311873",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isk Services LLC
• Giovanna Zoila Isla
• Riazul Islam, PSY.D.
• Lawrence J Israel, MD
• Fatmata Mohammed Jabbie, RN
• Walter Jachimowicz
• Brian Jackson, OTD
• Donald Wayne Jackson, LPC
• Jatai Jackson
• Londyn Andrea Jackson

• Corneal and Contact Management Optometrist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Corneal and Contact Management Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.