Bortnick & Furman, P.C.
Organization Active NPI Optometrist · Accomac, VA
NPI 1508048026 · NPPES record last updated Aug 29, 2023
Key facts
- NPI
- 1508048026
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- BORTNICK & FURMAN, P.C.
- Practice address
- 23079 Courthouse Ave
Accomac, VA 23301-1505 - Phone
- (757) 787-7040
- Fax
- (757) 787-2886
- NPI assigned
- Nov 27, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Mark Wayne Keyes, O.D.
- Title
- Optometrist/Partner
- Phone
- (757) 787-7040
Practitioners 3
-
Mark Wayne Keyes, O.D.
-
Kenneth Alan Bortnick, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120113000699 | VA | Part B Supplier - Clinic/Group Practice | 7214056217 |
Receives reassigned benefits from 2 practitioners Practice locations: Accomac, VA |
National Provider Directory
Locations
23079 Courthouse Ave
Accomac, VA 23301
Phone (757) 787-7040
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
23079 Courthouse Ave
Accomac, VA 23301-1505
Mailing address
23079 Courthouse Ave
Accomac, VA 23301-1505
Phone (757) 787-7040
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009205659 | Medicaid | VA | |
| 1508048026 | Medicaid | VA |
Other names
- Accomac Optometric Center
Other providers in Accomac, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.