NPIMap

Organization Active NPI

Eye Surgeons of Richmond, Inc.

Doing business as Virginia Eye Institute

  • Optometrist
  • Henrico, VA
National Provider Identifier
1528336385
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE SURGEONS OF RICHMOND, INC.
Doing business as
Virginia Eye Institute
Practice address
12018 W Broad St
Suite 100
Henrico, VA 23233-7689
Phone
(804) 287-4200
Fax
(804) 287-4210
NPI assigned
Dec 8, 2011
Last updated
Dec 8, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
VIRGINIA EYE INSTITUTEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Authorized official

Name
Mr. Eddie F Clark
Title
Chief Financial Officer
Phone
(804) 287-4236

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

12018 W Broad St
Suite 100
Henrico, VA 23233-7689

Mailing address

400 Westhampton Sta
Richmond, VA 23226-3330
Phone (804) 287-4200

Other names 1

  • Virginia Eye Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040407001285 VA Part B Supplier - Clinic/Group Practice 5799778320 Receives reassigned benefits from 48 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mechanicsville, VA; Richmond, VA; Prince George, VA; Henrico, VA; Chester, VA; Midlothian, VA
O20120410000485 VA DME Supplier - Physician - OptometristDME Supplier - Physician - Ophthalmology 5799778320 Practice locations: Henrico, VA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2093810Virginia Eye Institute12018 W Broad Street, Richmond, VA 23233Certificate of waiverApr 5, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eye Surgeons of Richmond Inc12018 W Broad St, Henrico, VA 23233-7796(804) 287-1380 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1992

National Provider Directory

National Provider Directory
Tax ID family
Eye Surgeons of Richmond4 organizations share this tax ID, including this one
Part of
Eye Surgeons of Richmond

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1528336385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WESTHAMPTON STA",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263330",
            "telephone_number": "804-287-4200",
            "fax_number": "804-287-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12018 W BROAD ST",
            "address_2": "SUITE 100",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232337689",
            "telephone_number": "804-287-4200",
            "fax_number": "804-287-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SURGEONS OF RICHMOND, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VIRGINIA EYE INSTITUTE",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "804-287-4236",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virginia Eye Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.