Charles Gamboa, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002328 Issued in VA

Practice address

1776 Eye St NW
Washington, DC 20006-3700

Phone

(202) 331-3931

Fax

(202) 331-3932

NPI assigned

Jun 27, 2014

Last updated

Mar 17, 2018By the provider in NPPES

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 MD, DC2 enrollments

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 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Myeyedr Optometry of DC, LLC

  dba MyEyeDr.

  • Optometrist
  • Washington, DC
  • NPI 1891105458
  Medicare reassignment NPD
• Myeyedr Optometry of Maryland, LLC

  dba MyEyeDr.

  • Optometrist
  • Clinton, MD
  • NPI 1497124796

  DC

  Medicare reassignment NPD
• Myeyedr Optometry of DC, LLC

  dba MyEyeDr.

  • Optometrist
  • Washington, DC
  • NPI 1114814381
  NPD
• Myeyedr Optometry of Maryland, LLC

  dba MyEyeDr.

  • Optometrist
  • Silver Spring, MD
  • NPI 1164996146
  NPD
• Myeyedr Optometry of Maryland, LLC

  dba MyEyeDr.

  • Optometrist
  • Laurel, MD
  • NPI 1972900058
  NPD

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1548675515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD",
            "address_2": "520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823990",
            "telephone_number": "703-847-8899",
            "fax_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 EYE ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200063700",
            "telephone_number": "202-331-3931",
            "fax_number": "202-331-3932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14465 Potomac Mills Rd",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221926807",
            "country_code": "US",
            "telephone_number": "703-494-6184",
            "fax_number": "703-499-9744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMBOA",
        "first_name": "CHARLES",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Gamble
• John Gamble
• Kasey Gamble
• Sheila Gamble
• Wayne Gamble
• Joyce Gambrah
• Raphaela Andrea Game, DO
• Selamensh Gamebo
• Godlove Gamuga Sanje
• Gabriel Harrison Gan, MPH, NRP

• Optometrist in Washington, DC
• Providers in Washington, DC by specialty
• Optometrist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.