Individual provider Active NPI

Susannah Neff, OD

  • Optometrist
  • Vienna, WV
National Provider Identifier
1336208040
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1818 Issued in MD
Practice address
1500 Grand Central Ave # 112&104
Vienna, WV 26105-1079
Phone
(304) 295-5025
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1818 MD Primary

Addresses

Primary practice location

1500 Grand Central Ave # 112&104
Vienna, WV 26105-1079

Mailing address

11103 West Ave
Suite 6
San Antonio, TX 78213-1370
Phone (210) 524-6509

Other practice location 1

6427 Baltimore Pike
Suite a
Catonsville, MD 21228
Phone (410) 788-9303

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address SN@eyedoctorviennawv.emadirect.md Direct Family EyeDoctors PLLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20151216001000 WV Practitioner - Optometry 0941274567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eyedoctors PLLCGroup PAC ID 3274708003, 3 clinicians

Practice addresses (Care Compare)

1500 Grand Central Ave
Suite 112
Vienna, WV 26105-1079
Phone (304) 295-5025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eyedoctors PLLC Optometrist CurrentSince Oct 14, 2015 Accepting new patients
Visionworks, Inc Past Accepting new patients
Visionworks Inc Optometrist Past Accepting new patients

Locations

1500 Grand Central Ave
Ste 112
Vienna, WV 26105
Phone (304) 295-5025

Interoperability endpoints

  • Direct secure messaging: sn@eyedoctorviennawv.emadirect.md

Organizations & group practices 3

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1336208040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "SUITE 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6509",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 GRAND CENTRAL AVE # 112&104",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261051079",
            "telephone_number": "304-295-5025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6427 BALTIMORE PIKE",
            "address_2": "SUITE A",
            "address_purpose": "LOCATION",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "21228",
            "country_code": "US",
            "telephone_number": "410-788-9303",
            "fax_number": "410-788-9432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEFF",
        "first_name": "SUSANNAH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SN@eyedoctorviennawv.emadirect.md",
            "affiliation": "Y",
            "affiliationName": "Family EyeDoctors PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1500 Grand Central Ave # 112&104",
            "city": "Vienna",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261051079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vienna, WV

Sources for this page

Verify at the official NPI Registry.