Organization Active NPI

New Vision Family Eye Clinic LLC

  • Optometrist
  • Leesburg, VA
National Provider Identifier
1396450300
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
NEW VISION FAMILY EYE CLINIC LLC
Practice address
420 Madison Trade PLZ SE
Leesburg, VA 20175-3761
Phone
(240) 636-1515
NPI assigned
Jan 16, 2023
Last updated
Jan 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Authorized official

Name
Marjan Tofigh, ODNPI 1407333073
Title
Employee
Phone
(240) 636-1515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

420 Madison Trade PLZ SE
Leesburg, VA 20175-3761

Mailing address

23936 Mill Wheel PL
Aldie, VA 20105-4006
Phone (240) 636-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230215000026 VA Part B Supplier - Clinic/Group Practice 3678945953 Receives reassigned benefits from 1 practitioner
Practice locations: Leesburg, VA

National Provider Directory

National Provider Directory

Locations

420 Madison Trade Plz SE
Leesburg, VA 20175
Phone (240) 636-1515

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1396450300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23936 MILL WHEEL PL",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201054006",
            "telephone_number": "240-636-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 MADISON TRADE PLZ SE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201753761",
            "telephone_number": "240-636-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW VISION FAMILY EYE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-14",
        "status": "A",
        "authorized_official_last_name": "TOFIGH",
        "authorized_official_first_name": "MARJAN",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "240-636-1515",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.