Organization Active NPI

Gainesville Eye Associates, LLC

Doing business as Gainesville Eye Associates

  • Ophthalmology Physician
  • Gainesville, VA
National Provider Identifier
1356518849
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101239485 Issued in VA
Legal business name
GAINESVILLE EYE ASSOCIATES, LLC
Doing business as
Gainesville Eye Associates
Practice address
7300 Heritage Village PLZ
Gainesville, VA 20155-3079
Phone
(703) 753-4733
NPI assigned
May 13, 2008
Last updated
May 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Authorized official

Name
Dr. Philip Ryong Chung, M.D.NPI 1902809684
Title
Owner
Phone
(703) 753-4733

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0101239485 VA Primary

Addresses

Primary practice location

7300 Heritage Village PLZ
Gainesville, VA 20155-3079

Mailing address

7300 Heritage Village PLZ
Gainesville, VA 20155-3079
Phone (703) 753-4733

Other names 1

  • Gainesville Eye Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081020000039 VA Part B Supplier - Clinic/Group Practice 7517025661 Receives reassigned benefits from 2 practitioners
Practice locations: Gainesville, VA
O20081215000087 DC Part B Supplier - Clinic/Group Practice 7517025661 Receives reassigned benefits from 1 practitioner
Practice locations: Reston, VA; Falls Church, VA; Fairfax, VA; Annandale, VA

National Provider Directory

National Provider Directory

Locations

7300 Heritage Village Plz
Gainesville, VA 20155
Phone (703) 753-4733

7300 Heritage Village Plz
#101
Gainesville, VA 20155
Phone (703) 753-4733

1860 Town Center Dr
Ste G100
Reston, VA 20190
Phone (703) 433-8700

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1356518849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 HERITAGE VILLAGE PLZ",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553079",
            "telephone_number": "703-753-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 HERITAGE VILLAGE PLZ",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553079",
            "telephone_number": "703-753-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAINESVILLE EYE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-13",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "RYONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-753-4733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101239485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gainesville Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.