Nicole Penke, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0101249998 Issued in VA

Practice address

8140 Ashton Ave Ste 120
Manassas, VA 20109-5699

Phone

(703) 361-3128

NPI assigned

Oct 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

State University of New York at Buffalo School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: npenke401815@direct.medicine.duke.edu

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.

• Duke Health Integrated Practice, Inc.

  • General Practice Physician
  • Durham, NC
  • NPI 1205553369
  Medicare reassignment Care Compare group NPD
• Dominion Eye Care, P.C.

  • Ophthalmology Physician
  • Manassas, VA
  • NPI 1285721431
  NPD (past)
• Chandler Eye Center

  • Ophthalmology Physician
  • Chandler, AZ
  • NPI 1649614124
  NPD (past)
• My Eye Consultants PLLC

  • Optometrist
  • Chandler, AZ
  • NPI 1427886019

  Ophthalmology

  NPD (past)
• Private Diagnostic Clinic, PLLC

  • General Practice Physician
  • Durham, NC
  • NPI 1457389033

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1356530331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 N QUINN ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8140 ASHTON AVE STE 120",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095699",
            "telephone_number": "703-361-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENKE",
        "first_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57013584",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101249998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Associates of Prince William County, LLC
• Pediatric Practice,PC
• Pediatricare of Northern Virginia, P.C.
• Pediatrix Medical Group PC
• Kevin Edward Peltier I, MD
• Anna Penna, MD
• Victoria Pennant, LPC
• Tricia Marie Carr Peny, MPT
• Caitilin Perez, MFN, RDN
• Katherine Michele Perez, LPC

• Ophthalmology Physician in Manassas, VA
• Providers in Manassas, VA by specialty
• Ophthalmology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; 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.