Vijayata Dham, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0620000100 Issued in VA

Practice address

4114 Innslake Dr
Glen Allen, VA 23060-3344

Phone

(804) 217-9883

Fax

(804) 217-9065

NPI assigned

Jun 26, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Vision Care of RichmondGroup PAC ID 6103974217, 10 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Family Vision Care of Richmond

  • Optometrist
  • Glen Allen, VA
  • NPI 1336361997
  Medicare reassignment Care Compare group NPD
• Virginia Eye Consultants Inc

  • Ophthalmology Physician
  • Norfolk, VA
  • NPI 1992727820

  Optometrist

  NPD
• Community Bridges, Inc.

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1508124488
  NPD (past)

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1407296114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 INNSLAKE DR",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603344",
            "telephone_number": "804-217-9883",
            "fax_number": "804-217-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4114 INNSLAKE DR",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603344",
            "telephone_number": "804-217-9883",
            "fax_number": "804-217-9065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHAM",
        "first_name": "VIJAYATA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0620000100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethann Wise Detwiler, M.A., L.P.C.
• Devine Physical Therapy and Wellness
• Andrea Devooght
• Thomas Merrill Dewire Sr., M.D.
• Aditya Dhakar, DDS
• Diamedix Healthcare LLC
• Diamonds and Jewels Medical Transport
• Ana Diaz Macias, PHARM.D.
• Kathy Dicostanzo, BCBA
• Kimberly Lancaster Didra, MS, CCC- SLP

• Optometrist in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.