Individual provider Active NPI

Mohammad Ashfaq, OD

  • Optometrist
  • Woodbridge, VA
National Provider Identifier
1396992145
Registry record updated Oct 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001741 Issued in VA
Practice address
14130 Noblewood PLZ
Unit 105
Woodbridge, VA 22193-1464
Phone
(703) 878-2020
Fax
(703) 878-2020
NPI assigned
Aug 23, 2008
Last updated
Oct 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2098 MD
Optometrist 152W00000X 0618001741 VA Primary

Addresses

Primary practice location

14130 Noblewood PLZ
Unit 105
Woodbridge, VA 22193-1464

Mailing address

14599 Charity CT
Woodbridge, VA 22193-1200
Phone (703) 878-2020

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
I20111205000810 VA Practitioner - Optometry 5193881381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA2098MDMDOptometrist
0618001741VAMDOptometrist

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": "1219449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1396992145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14599 CHARITY CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931200",
            "telephone_number": "703-878-2020",
            "fax_number": "703-878-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14130 NOBLEWOOD PLZ",
            "address_2": "UNIT 105",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931464",
            "telephone_number": "703-878-2020",
            "fax_number": "703-878-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHFAQ",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-23",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2098",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

Verify at the official NPI Registry.