Individual provider Active NPI

Kenneth Michael Karlin, M.D.

  • Ophthalmology Physician
  • Reston, VA
National Provider Identifier
1528061074
Registry record updated Nov 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101037922 Issued in VA
Practice address
1800 Town Center Dr
Ste 317
Reston, VA 20190-3239
Phone
(703) 437-3900
Fax
(703) 437-9426
NPI assigned
May 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0101037922 VA Primary

Addresses

Primary practice location

1800 Town Center Dr
Ste 317
Reston, VA 20190-3239

Mailing address

1800 Town Center Dr
Ste 317
Reston, VA 20190-3239
Phone (703) 437-3900

Other identifiers 4

IdentifierTypeStateIssuer
027283OtherVAANTHEM
0800026OtherVAUNITED HEALTHCARE
6396143MedicaidVA
4086959OtherVAAETNA

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
I20110309000601 DC Practitioner - Ophthalmology 9234164567 Reassigns benefits to 1 organization
I20180702003563 VA Practitioner - Ophthalmology 9234164567 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101037922VAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince May 25, 2018 Accepting new patients
Privia Medical Group, LLC CurrentSince May 25, 2018 Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

8644 Sudley Rd
#220
Manassas, VA 20110

6845 Elm St
Ste 611
McLean, VA 22101
Phone (703) 356-6880

1800 Town Center Dr
Ste 317
Reston, VA 20190
Phone (703) 356-6880

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416009600000",
    "number": "1528061074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 TOWN CENTER DR",
            "address_2": "STE 317",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903239",
            "telephone_number": "703-437-3900",
            "fax_number": "703-437-9426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 TOWN CENTER DR",
            "address_2": "STE 317",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903239",
            "telephone_number": "703-437-3900",
            "fax_number": "703-437-9426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARLIN",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2014-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101037922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "027283",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0800026",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6396143",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4086959",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.