Stefan Kristoph Young, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001620 Issued in VA

Practice address

2253C Old Bridge Rd
Lake Ridge, VA 22192-3025

Phone

(703) 494-8900

Fax

(703) 494-2092

NPI assigned

Nov 8, 2006

Last updated

Feb 4, 2022By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

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 2

Specialty

Optometry

Education

Southern College of Optometry, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

May and Hettler, O.D., PLLCGroup PAC ID 4981653433, 12 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• May & Hettler, O.D., PLLC

  • Optometrist
  • Sterling, VA
  • NPI 1295939304
  Medicare reassignment Care Compare group NPD
• May & Hettler, O.D., PLLC

  • Optometrist
  • Alexandria, VA
  • NPI 1386689081

  DC

  Medicare reassignment
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  dba Kaiser Permanente Annapolis Medical Center

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC

  Medicare reassignment
• May & Hettler, O.D., PLLC

  • Optometrist
  • Manassas, VA
  • NPI 1548464654
  NPD
• May & Hettler, O.D., PLLC

  • Optometrist
  • Falls Church, VA
  • NPI 1942404074
  NPD
• May & Hettler, O.D., PLLC

  • Optometrist
  • Alexandria, VA
  • NPI 1366646473
  NPD (past)
• MPG LLC

  • Optometrist
  • Staunton, VA
  • NPI 1962574673
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1336219211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208869",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753208869",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253C OLD BRIDGE RD",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221923025",
            "telephone_number": "703-494-8900",
            "fax_number": "703-494-2092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8112 Arlington Blvd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220421002",
            "country_code": "US",
            "telephone_number": "703-876-5766",
            "fax_number": "703-876-4936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9150 Key Commons Ct",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201105300",
            "country_code": "US",
            "telephone_number": "703-369-1302",
            "fax_number": "703-369-9732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2352 Plank Rd",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224014900",
            "country_code": "US",
            "telephone_number": "540-374-1100",
            "fax_number": "540-374-1214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6756 Richmond Hwy",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223066701",
            "country_code": "US",
            "telephone_number": "703-768-1677",
            "fax_number": "703-765-6483",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8112 Arlington Blvd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220421002",
            "country_code": "US",
            "telephone_number": "703-876-5766",
            "fax_number": "703-876-4936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6098 Franconia Rd",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223101742",
            "country_code": "US",
            "telephone_number": "703-971-0544",
            "fax_number": "703-719-7627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21800 Towncenter Plz Ste 259",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201641886",
            "country_code": "US",
            "telephone_number": "703-430-0444",
            "fax_number": "703-430-8516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "STEFAN",
        "middle_name": "KRISTOPH",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8112 Arlington Blvd",
            "city": "Falls Church",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220421002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Mbene Wainaina, FNP
• Wellness With Rachita
• Westminster Presbyterian Retirement Community, Inc. (Westminster At Lake Ridge)
• Sara Woodby-Brown, N.P.
• R Alexandria Wright, PA-C
• Norma Lizette Zapata-de Perez, MD

• Optometrist in Lake Ridge, VA
• Providers in Lake Ridge, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.