Individual provider Active NPI

Homa Julie Niazi, O.D.

  • Optometrist
  • Gaithersburg, MD
National Provider Identifier
1346391893
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1896 Issued in MD
Practice address
701 Russell Ave
Lenscrafters, Lakeforest Mall
Gaithersburg, MD 20877-2631
Phone
(301) 963-0050
Fax
(301) 963-7773
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1896 MD Primary

Addresses

Primary practice location

701 Russell Ave
Lenscrafters, Lakeforest Mall
Gaithersburg, MD 20877-2631

Mailing address

13016 Tamarack Rd
Silver Spring, MD 20904-1543
Phone (301) 257-3831

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20211211000005 VA Practitioner - Optometry 4082004726 Reassigns benefits to 1 organization
I20211215000486 DC Practitioner - Optometry 4082004726 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA1896MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Poth, O.D. and Associates, P.C. Optometrist CurrentSince Sep 9, 2021 Accepting new patients
Daniel Poth, O.D. and Associates, P.C. Optometrist CurrentSince Sep 9, 2021 Accepting new patients

Locations

8125 Sudley Rd
Manassas, VA 20109
Phone (703) 330-0090

11130L South Lakes Dr
Reston, VA 20191
Phone (703) 471-1012

8424 Old Keene Mill Rd
West Springfield, VA 22152
Phone (703) 288-1978

2700 Potomac Mills Cir
Ste 105
Woodbridge, VA 22192
Phone (703) 494-0660

Organizations & group practices 2

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346391893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13016 TAMARACK RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041543",
            "telephone_number": "301-257-3831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 RUSSELL AVE",
            "address_2": "LENSCRAFTERS, LAKEFOREST MALL",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208772631",
            "telephone_number": "301-963-0050",
            "fax_number": "301-963-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIAZI",
        "first_name": "HOMA",
        "middle_name": "JULIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.