Individual provider Active NPI

Alan C Egge, M.D.

  • Ophthalmology Physician
  • Manassas, VA
National Provider Identifier
1376515759
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101036560 Issued in VA
Practice address
8140 Ashton Ave
Ste 120
Manassas, VA 20109-5698
Phone
(703) 361-3128
Fax
(703) 361-3670
NPI assigned
Feb 1, 2006
Last updated
May 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0101036560 VA Primary

Addresses

Primary practice location

8140 Ashton Ave
Ste 120
Manassas, VA 20109-5698

Mailing address

8140 Ashton Ave
Ste 120
Manassas, VA 20109-5698
Phone (703) 361-3128

Other identifiers 1

IdentifierTypeStateIssuer
006362303MedicaidVA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120328000837 VA Practitioner - Ophthalmology 0941228738 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101036560VAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Eye Care, P.C. Ophthalmology CurrentSince Jul 22, 1985 Accepting new patients

Locations

8140 Ashton Ave
Ste 120
Manassas, VA 20109
Phone (703) 361-3128

8640 Sudley Rd
Ste 207
Manassas, VA 20110
Phone (703) 361-3128

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1376515759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8140 ASHTON AVE",
            "address_2": "STE 120",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095698",
            "telephone_number": "703-361-3128",
            "fax_number": "703-361-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8140 ASHTON AVE",
            "address_2": "STE 120",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201095698",
            "telephone_number": "703-361-3128",
            "fax_number": "703-361-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGGE",
        "first_name": "ALAN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101036560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006362303",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.