Individual provider Active NPI

Nick Neagle, OD

  • Optometrist
  • Washington, DC
National Provider Identifier
1417006057
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OP532 Issued in DC
Practice address
650 Massachusetts Ave NW
Washington, DC 20001-3796
Phone
(202) 898-1060
Fax
(202) 898-0472
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X I3-0001265 DE
Optometrist 152W00000X OP532 DC Primary

Addresses

Primary practice location

650 Massachusetts Ave NW
Washington, DC 20001-3796

Mailing address

1950 Old Gallows Rd
Suite 520
Vienna, VA 22182-3990
Phone (703) 847-8899

Other identifiers 1

IdentifierTypeStateIssuer
0001138722MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, DE2 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
I20070509000667 DC Practitioner - Optometry 4981700853 Reassigns benefits to 1 organization
I20070530000567 DE Practitioner - Optometry 4981700853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of DC LLCGroup PAC ID 6305063371, 15 clinicians

Practice addresses (Care Compare)

650 Massachusetts Ave NW
Washington, DC 20001-3796
Phone (202) 898-1060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OP532DCMDOptometrist
I3-0001265DEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of DC, LLC Optometrist CurrentSince Jun 16, 2014 Accepting new patients
Myeyedr Optometry of Delaware PA Optometrist Current Accepting new patients
Myeyedr Optometry of DC, LLC Optometrist CurrentSince Jun 16, 2014 Accepting new patients
Myeyedr Optometry of Delaware PA Optometrist CurrentSince Jan 9, 2020 Accepting new patients
Myeyedr Optometry of Delaware PA Optometrist CurrentSince Jan 9, 2020 Accepting new patients
Myeyedr Optometry of DC, LLC Optometrist Current Accepting new patients
Sussex Eye Center PA Optometrist PastSince Nov 10, 1993 Accepting new patients
Peninsula Eye Center PA Past Accepting new patients

Locations

1330 Connecticut Ave NW
Washington, DC 20036
Phone (202) 785-5700

3418 Wisconsin Ave NW
Washington, DC 20016
Phone (202) 547-0956

800 K St NW
Ste 64
Washington, DC 20001
Phone (202) 898-1060

1776 G St NW
Ste 104
Washington, DC 20006
Phone (202) 298-6878

650 Massachusetts Ave NW
Washington, DC 20001
Phone (202) 898-1060

233 Pennsylvania Ave SE
Washington, DC 20003
Phone (202) 544-9220

650 Massachusetts Ave NW
Ste 140
Washington, DC 20001
Phone (202) 898-1060

1744 L St NW
Washington, DC 20036
Phone (202) 463-6300

635 Pennsylvania Ave SE
Washington, DC 20003
Phone (202) 546-2838

1404 Forrest Ave
Ste 1
Dover, DE 19904
Phone (302) 346-2020

885 S Governors Ave
Dover, DE 19904
Phone (302) 734-5861

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 8

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1417006057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD",
            "address_2": "SUITE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823990",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 MASSACHUSETTS AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200013796",
            "telephone_number": "202-898-1060",
            "fax_number": "202-898-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAGLE",
        "first_name": "NICK",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DE",
            "license": "I3-0001265",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DC",
            "license": "OP532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001138722",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.