Individual provider Active NPI

Grace Kim Oei, OD

  • Optometrist
  • Leesburg, VA
National Provider Identifier
1548424823
Registry record updated Nov 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001693 Issued in VA
Practice address
1300 Edwards Ferry Rd NE Ste a
Leesburg, VA 20176-3355
Phone
(703) 771-4181
NPI assigned
Jul 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 007238 NY
Optometrist 152W00000X 0618001693 VA Primary

Addresses

Primary practice location

1300 Edwards Ferry Rd NE Ste a
Leesburg, VA 20176-3355

Mailing address

1300 Edwards Ferry Rd NE Ste a
Leesburg, VA 20176-3355
Phone (703) 771-4181

Other practice location 1

7373 Boston Blvd Ste A
Springfield, VA 22153-2805
Phone (703) 455-6002

Other names 1

  • Grace Kim Bernardez-Fu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0618001693VAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732924800000",
    "number": "1548424823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 EDWARDS FERRY RD NE STE A",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763355",
            "telephone_number": "703-771-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 EDWARDS FERRY RD NE STE A",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201763355",
            "telephone_number": "703-771-4181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7373 Boston Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "VA",
            "postal_code": "221532805",
            "country_code": "US",
            "telephone_number": "703-455-6002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OEI",
        "first_name": "GRACE",
        "middle_name": "KIM",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-15",
        "last_updated": "2024-11-30",
        "certification_date": "2024-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007238",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "BERNARDEZ-FU",
            "middle_name": "KIM",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.