Individual provider Active NPI

Yash Dave

  • Optometrist
  • Hampton, VA
National Provider Identifier
1417521287
Registry record updated Jun 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT007114 Issued in OH
Practice address
115 Coliseum Xing Ste 58
Hampton, VA 23666-5971
Phone
(757) 751-6236
NPI assigned
May 17, 2021
Last updated
Jun 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT007114 OH Primary
Optometrist 152W00000X 0618003008 VA

Addresses

Primary practice location

115 Coliseum Xing Ste 58
Hampton, VA 23666-5971

Mailing address

7307 Crosscut Rd
Holland, OH 43528-9564
Phone (757) 981-6616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20251219001580 OH Practitioner - Optometry 3375038052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peters Family Eyecare AssociatesGroup PAC ID 6002842028, 3 clinicians

Practice addresses (Care Compare)

219 S Main St
Bryan, OH 43506-1759
Phone (419) 636-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618003008VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Peters Family Eyecare Associates Optometrist CurrentSince Dec 3, 2025 Accepting new patients

Locations

219 S Main St
Bryan, OH 43506
Phone (419) 636-3937

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": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782604800000",
    "number": "1417521287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7307 CROSSCUT RD",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435289564",
            "telephone_number": "757-981-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 COLISEUM XING STE 58",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665971",
            "telephone_number": "757-751-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "YASH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2026-06-28",
        "certification_date": "2026-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT007114",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618003008",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.