Eye Plastic Associates PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0101047 Issued in VA

Legal business name

EYE PLASTIC ASSOCIATES PC

Practice address

3700 Joseph Siewick Dr
Suite 400
Fairfax, VA 22033-1744

Phone

(703) 620-4300

Fax

(703) 620-4367

NPI assigned

Aug 1, 2007

Last updated

Feb 25, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kim Lundmark

Title

Office Manager

Phone

(703) 620-4300

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

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.

• Kevin R Scott, M.D.

  • Ophthalmology Physician
  • Fairfax, VA
  • NPI 1962476713

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267056000000",
    "number": "1386834620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR",
            "address_2": "SUITE 400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331744",
            "telephone_number": "703-620-4300",
            "fax_number": "703-620-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 JOSEPH SIEWICK DR",
            "address_2": "SUITE 400",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220331744",
            "telephone_number": "703-620-4300",
            "fax_number": "703-620-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE PLASTIC ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2010-02-25",
        "status": "A",
        "authorized_official_last_name": "LUNDMARK",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "703-620-4300"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006305245",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oludare Ewetusa, PTA
• Exceeding Homecare LLC
• Excel Rehabilitation, PLLC
• Eyad Abu Hamda MD PC
• Eye Physicians and Surgeons Inc
• Eye Specialists and Surgeons of Northern Virginia, LLC
• Eyecare Center Corp
• Eyegaze Inc.
• Eyelab
• Ez Living LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; 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.