Kulsoom T. Murtaza, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001931 Issued in VA

Practice address

2015 Waterside Rd
Prince George, VA 23875-1265

Phone

(804) 733-7300

Fax

(804) 733-7390

NPI assigned

Aug 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Legacy Eye Care

  • Optometrist
  • Petersburg, VA
  • NPI 1033470539
  Medicare reassignment NPD
• Lansing Ophthalmology, P.C.

  • Optometrist
  • East Lansing, MI
  • NPI 1265415301
  NPD (past)
• Lansing Ophthalmology, P.C.

  • Ophthalmology Physician
  • East Lansing, MI
  • NPI 1962485342

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329177600000",
    "number": "1639181472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WESTHAMPTON STA",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263330",
            "telephone_number": "804-287-4200",
            "fax_number": "804-287-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 WATERSIDE RD",
            "city": "PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238751265",
            "telephone_number": "804-733-7300",
            "fax_number": "804-733-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURTAZA",
        "first_name": "KULSOOM",
        "middle_name": "T.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2012-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "KM003908",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "900C363570",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHPMM",
            "identifier": "200000002790",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0618001931",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Minutemen Radiology Inc
• Kelsey S Mitchell, DPT
• Kimberly Mondezie, LPC, CSAC, CRC
• Sarah Osborne Morris, PT
• Rebekah Sykes Moss
• My Father'S House,LLC
• Shobha Rani Nalluri, MD
• Skyler Colleen Naves
• Gabrielle Katherine Nelson
• Neuro Care of Virginia PC

• Optometrist in Prince George, VA
• Providers in Prince George, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; 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.