NPIMap

Organization Active NPI

Michael J. Bermel, O.D., P.C.

  • Optometrist
  • Gainesville, VA
National Provider Identifier
1568525616
Registry record updated Dec 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000011 Issued in VA
Legal business name
MICHAEL J. BERMEL, O.D., P.C.
Practice address
7531 Somerset Crossing Dr
Gainesville, VA 20155-4873
Phone
(571) 261-5100
Fax
(571) 261-5103
NPI assigned
Dec 19, 2006
Last updated
Dec 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2014

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

Authorized official

Name
Ms. Renee Jean Morrow
Title
Practice Administrator
Phone
(703) 777-3455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000011 VA Primary

Addresses

Primary practice location

7531 Somerset Crossing Dr
Gainesville, VA 20155-4873

Mailing address

55 A Catoctin Circle NE
Leesburg, VA 20176
Phone (703) 777-3455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120424000726 VA Part B Supplier - Clinic/Group Practice 0244492007 Receives reassigned benefits from 9 practitioners
Practice locations: Leesburg, VA; Gainesville, VA; Ashburn, VA
O20150216001182 DC Part B Supplier - Clinic/Group Practice 0244492007 Receives reassigned benefits from 2 practitioners
Practice locations: Fairfax, VA

National Provider Directory

National Provider Directory

Locations

10640 Main St
Fairfax, VA 22030
Phone (703) 691-2020

10640 Main St
Ste 100
Fairfax, VA 22030
Phone (703) 691-0755

7531 Somerset Crossing Dr
Gainesville, VA 20155
Phone (571) 261-5100

7909 Stonewall Shops Sq
Gainesville, VA 20155

7945 Stonewall Shops Sq
Gainesville, VA 20155

55 Catoctin Cir NE
Ste A
Leesburg, VA 20176
Phone (703) 777-3455

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417737600000",
    "number": "1568525616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 A CATOCTIN CIRCLE NE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "20176",
            "telephone_number": "703-777-3455",
            "fax_number": "703-777-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7531 SOMERSET CROSSING DR",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201554873",
            "telephone_number": "571-261-5100",
            "fax_number": "571-261-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. BERMEL, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2014-12-05",
        "status": "A",
        "authorized_official_last_name": "MORROW",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "703-777-3455",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.