Individual provider Active NPI

Anup Panjwani, O.D

  • Optometrist
  • Alexandria, VA
National Provider Identifier
1497880512
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2294 Issued in MD
Practice address
3838 Watkins Mill Dr
Alexandria, VA 22304-6448
Phone
(904) 502-6075
Fax
(904) 207-7933
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3506 FL
Optometrist 152W00000X 0618002102 VA
Optometrist 152W00000X TA2294 MD Primary

Addresses

Primary practice location

3838 Watkins Mill Dr
Alexandria, VA 22304-6448

Mailing address

3838 Watkins Mill Dr
Alexandria, VA 22304-6448
Phone (904) 502-6075

Other identifiers 2

IdentifierTypeStateIssuer
003659300MedicaidFL
052828500MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, VA2 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
I20120626000535 MD Practitioner - Optometry 5991719106 Reassigns benefits to 1 organization
I20130110000363 VA Practitioner - Optometry 5991719106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Anup K Panjwani and Associates IncGroup PAC ID 3375711997, 2 clinicians

Practice addresses (Care Compare)

11930 Acton LN
Waldorf, MD 20601-3689
Phone (240) 435-4822

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA2294MDMDOptometrist
0618002102VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Anup K Panjwani and Associates Optometrist Current Accepting new patients
Warrenton Eye Center LLC Optometrist CurrentSince Oct 19, 2012 Accepting new patients
Dr Anup K Panjwani and Associates Inc Optometrist CurrentSince Jul 22, 2011 Accepting new patients

Locations

9501 Arlington Expy
Jacksonville, FL 32225
Phone (904) 721-1319

6767 103rd St
Jacksonville, FL 32210
Phone (904) 502-6075

40 Drury Dr
La Plata, MD 20646
Phone (301) 392-9106

3549 Russett Grn E
Laurel, MD 20724
Phone (240) 303-3437

11930 Acton Ln
Waldorf, MD 20601
Phone (240) 435-4822

700 James Madison Hwy
Warrenton, VA 20186
Phone (540) 216-0816

Organizations & group practices 3

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1497880512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 WATKINS MILL DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223046448",
            "telephone_number": "904-502-6075",
            "fax_number": "904-207-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 WATKINS MILL DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223046448",
            "telephone_number": "904-502-6075",
            "fax_number": "904-207-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANJWANI",
        "first_name": "ANUP",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3506",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002102",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003659300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052828500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.