Benjamin Kwak, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618003353 Issued in VA

Practice address

508 Fletcher Dr
Warrenton, VA 20186-2183

Phone

(540) 216-7632

NPI assigned

Nov 22, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Warrenton Eye AssociatesGroup PAC ID 4082995949, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Warrenton Eye Associates

  • Optometrist
  • Warrenton, VA
  • NPI 1356794697
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1700611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1548035249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5436 HEREDITY LN",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201551328",
            "telephone_number": "703-999-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 FLETCHER DR",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201862183",
            "telephone_number": "540-216-7632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAK",
        "first_name": "BENJAMIN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-22",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618003353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael G. Koerner, DDS
• Anupama T Kommu, PSYD
• Chandrasekhar Kommu, M.D.
• Michael C Kramm, MS, CTP, CGP
• Joseph Lee Krofcheck, M.D.
• Linda L Land, CRNA
• Jessica Anne Landrum-Webb, NP-C
• Lora Larcomb, MA, RESIDENT-MFT
• Laser Dental Arts PLLC
• Aamir Latif, MD

• Optometrist in Warrenton, VA
• Providers in Warrenton, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.