Mark D. Livaditis, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000747 Issued in VA

Practice address

5250 Port Royal Rd # G
Springfield, VA 22151-2117

Phone

(703) 321-7780

Fax

(703) 321-2205

NPI assigned

Feb 20, 2007

Last updated

Oct 16, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 DC

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, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mark D. Livaditis, O.D.

  • Optometrist
  • Springfield, VA
  • NPI 1912146499
  Authorized official Same address or phone

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255651200000",
    "number": "1427193267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 PORT ROYAL RD # G",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221512117",
            "telephone_number": "703-321-7780",
            "fax_number": "703-321-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 PORT ROYAL RD # G",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221512117",
            "telephone_number": "703-321-7780",
            "fax_number": "703-321-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVADITIS",
        "first_name": "MARK",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2009-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Alfred Lindsey, DENTIST
• Steven Ellis Lipson, D.P.M.
• Meron Getaneh Lisanework
• Jeannette Lucille Liu, O.D.
• Christian Noelle Liuzza, PHARMD
• Nora L. Locke, LCSW
• Amel Logan, LPC
• Erin C Stabeck Long
• Sarah Long, PHARM.D.
• Elizabeth Longo, MS OTR/L

• Optometrist in Springfield, VA
• Providers in Springfield, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2009; 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.