Individual provider Active NPI

Bob Dale Lein, O.D.

  • Optometrist
  • Winchester, VA
National Provider Identifier
1609904945
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001463 Issued in VA
Practice address
1845 Plaza Dr
Winchester, VA 22601-6365
Phone
(540) 662-4512
Fax
(540) 722-5284
NPI assigned
Feb 28, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001463 VA Primary

Addresses

Primary practice location

1845 Plaza Dr
Winchester, VA 22601-6365

Mailing address

136 Linden Dr Ste 104
Winchester, VA 22601-6900
Phone (540) 678-3588

Other identifiers 1

IdentifierTypeStateIssuer
P00916029OtherVARR MEDICARE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110119000757 VA Practitioner - Optometry 7517146848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
993NEMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
An Eye for the Eye, PC Optometrist Past Accepting new patients

Organizations & group practices 1

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1609904945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 LINDEN DR STE 104",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016900",
            "telephone_number": "540-678-3588",
            "fax_number": "540-678-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 PLAZA DR",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016365",
            "telephone_number": "540-662-4512",
            "fax_number": "540-722-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIN",
        "first_name": "BOB",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00916029",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.