Individual provider Active NPI

James Ronald Komornik, OD

  • Optometrist
  • Norfolk, VA
National Provider Identifier
1366971574
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002581 Issued in VA
Practice address
4035 E Ocean View Ave Ste 200
Norfolk, VA 23518-1612
Phone
(757) 355-5553
NPI assigned
Jun 9, 2017
Last updated
Jun 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618002581 VA Primary

Addresses

Primary practice location

4035 E Ocean View Ave Ste 200
Norfolk, VA 23518-1612

Mailing address

4035 E Ocean View Ave Ste 200
Norfolk, VA 23518-1612
Phone (757) 355-5553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20171120003138 VA Practitioner - Optometry 5597022939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9573 Shore Dr
Suite E
Norfolk, VA 23518-1722
Phone (757) 355-5553

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618002581VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. James Komornik LLC Optometrist CurrentSince Nov 13, 2018 Accepting new patients

Locations

4035 E Ocean View Ave
Ste 200
Norfolk, VA 23518
Phone (757) 355-5553

9573 Shore Dr
Ste E
Norfolk, VA 23518
Phone (757) 355-5553

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1366971574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4035 E OCEAN VIEW AVE STE 200",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235181612",
            "telephone_number": "757-355-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4035 E OCEAN VIEW AVE STE 200",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235181612",
            "telephone_number": "757-355-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMORNIK",
        "first_name": "JAMES",
        "middle_name": "RONALD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-09",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.