Individual provider Active NPI

Cynthia A Koza, O.D.

  • Optometrist
  • Glen Allen, VA
National Provider Identifier
1568774271
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001964 Issued in VA
Practice address
4600 Cox Road
Suite 120
Glen Allen, VA 23060
Phone
(804) 270-0330
Fax
(804) 270-1003
NPI assigned
Jul 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001964 VA Primary

Addresses

Primary practice location

4600 Cox Road
Suite 120
Glen Allen, VA 23060

Mailing address

4600 Cox Road
Suite 120
Glen Allen, VA 23060
Phone (804) 270-0330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20181115000316 PA Practitioner - Optometry 4981887163 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618001964VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrews Eye Corporation Optometrist CurrentSince Nov 1, 2020 Accepting new patients
Horizon Family Eye Care, PLLC Optometrist Current Accepting new patients
Wolfram H Andrews Optometrist PastSince Nov 1, 2020 Accepting new patients

Locations

117 W Main St
New Holland, PA 17557
Phone (717) 354-2020

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1568774271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 COX ROAD",
            "address_2": "SUITE 120",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "23060",
            "telephone_number": "804-270-0330",
            "fax_number": "804-270-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 COX ROAD",
            "address_2": "SUITE 120",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "23060",
            "telephone_number": "804-270-0330",
            "fax_number": "804-270-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZA",
        "first_name": "CYNTHIA",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-10",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

Verify at the official NPI Registry.