Individual provider Active NPI

Nisha Raman Patel, M.D.

  • Ophthalmology Physician
  • Reston, VA
National Provider Identifier
1518173079
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101241432 Issued in VA
Practice address
12110 Sunset Hills Rd
Suite C50
Reston, VA 20190-5852
Phone
(703) 834-9777
Fax
(703) 834-8187
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0101241432 VA Primary
Ophthalmology Physician 207W00000X 240173 NY

Addresses

Primary practice location

12110 Sunset Hills Rd
Suite C50
Reston, VA 20190-5852

Mailing address

12110 Sunset Hills Rd
Suite C50
Reston, VA 20190-5852
Phone (703) 834-9777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070926000505 DC Practitioner - Ophthalmology 3678668365 Reassigns benefits to 2 organizations
I20180820001694 VA Practitioner - Ophthalmology 3678668365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nova Eye MD IncGroup PAC ID 0244392637, 2 clinicians

Practice addresses (Care Compare)

15195 Heathcote Blvd
Suite 210
Haymarket, VA 20169-6245
Phone (571) 455-3800

407 Church St NE
Suite E
Vienna, VA 22180-4737
Phone (703) 263-3147

5900 Fort Dr
Suite 425
Centreville, VA 20121-2471
Phone (703) 263-3147

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
240173NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nisha Patel MD PC Ophthalmology CurrentSince Jan 20, 2014 Accepting new patients
Nova Eye MD, Inc. Ophthalmology CurrentSince Aug 29, 2008 Accepting new patients
Jacqueline D Griffiths MD PC Ophthalmology PastSince Nov 15, 1999 Accepting new patients

Locations

5900 Fort Dr
Ste 425
Centreville, VA 20121
Phone (703) 263-3147

15195 Heathcote Blvd
Ste 210
Haymarket, VA 20169
Phone (571) 445-3800

407 Church St NE
Ste E
Vienna, VA 22180
Phone (301) 571-2000

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1518173079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 SUNSET HILLS RD",
            "address_2": "SUITE C50",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905852",
            "telephone_number": "703-834-9777",
            "fax_number": "703-834-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12110 SUNSET HILLS RD",
            "address_2": "SUITE C50",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905852",
            "telephone_number": "703-834-9777",
            "fax_number": "703-834-8187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NISHA",
        "middle_name": "RAMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101241432",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "240173",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.