Individual provider Active NPI

Heloi Elaine Stark, O.D.

  • Optometrist
  • Fairfax, VA
National Provider Identifier
1376563874
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000366 Issued in VA
Practice address
3900 Jermantown Rd
Suite 170
Fairfax, VA 22030-4900
Phone
(703) 385-6134
NPI assigned
Jul 20, 2006
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000366 VA Primary
Optometrist 152W00000X TA1262 MD
Optometrist 152W00000X OP754 DC

Addresses

Primary practice location

3900 Jermantown Rd
Suite 170
Fairfax, VA 22030-4900

Mailing address

25869 Pinebluff Dr
South Riding, VA 20152-1725
Phone (703) 542-6728

Other identifiers 1

IdentifierTypeStateIssuer
54-1969118OtherTAX ID

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
I20200420002546 VA Practitioner - Optometry 0547690208 Reassigns benefits to 1 organization
I20200520001536 DC Practitioner - Optometry 0547690208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Specialists and Surgeons of Northern Virginia LLCGroup PAC ID 1658672886, 11 clinicians

Practice addresses (Care Compare)

3998 Fair Ridge Dr
Suite 105
Fairfax, VA 22033-2980
Phone (571) 349-2191

7915 Lake Manassas Dr
Suite 210
Gainesville, VA 20155-3259
Phone (571) 349-2191

Merit-based Incentive Payment System (MIPS)

Final score
92.73 of 100Reported as group
Quality
100
Improvement activities
40
Cost
75.78

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OP754DCMDOptometrist
TA1262MDMDOptometrist
0618000366VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Specialists and Surgeons of Northern Virginia, LLC CurrentSince Sep 9, 2024 Accepting new patients
Associates in Eyecare Bristow PC PastSince Jun 1, 2020 Accepting new patients

Locations

3998 Fair Ridge Dr
Fairfax, VA 22033
Phone (571) 349-2191

3998 Fair Ridge Dr
Ste 105
Fairfax, VA 22033
Phone (571) 349-2191

7915 Lake Manassas Dr
Ste 210
Gainesville, VA 20155
Phone (571) 349-2191

8644 Sudley Rd
Ste 201
Manassas, VA 20110
Phone (571) 349-2191

Interoperability endpoints

  • Direct secure messaging: hstark@essnv.intellechartdirect.net
  • Direct secure messaging: hstark@eps1959.srs-direct.com

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376563874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25869 PINEBLUFF DR",
            "city": "SOUTH RIDING",
            "state": "VA",
            "postal_code": "201521725",
            "telephone_number": "703-542-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 JERMANTOWN RD",
            "address_2": "SUITE 170",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304900",
            "telephone_number": "703-385-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "HELOI",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000366",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1262",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DC",
            "license": "OP754",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "54-1969118",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.