Peyam Mojallal OD and Associates

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001051 Issued in VA

Legal business name

PEYAM MOJALLAL OD AND ASSOCIATES

Practice address

20600 Gordon Park SQ
Suite 150
Ashburn, VA 20147-3145

Phone

(703) 723-7117

NPI assigned

Feb 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Peyam Mojallal, ODNPI 1154378511

Title

Owner President

Phone

(703) 723-3433

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peyam Mojallal, OD

  • Low Vision Rehabilitation Optometrist
  • Ashburn, VA
  • NPI 1154378511

  DC, Optometrist, VA

  Medicare reassignment NPD Authorized official
• Solmaz Farajnia, OD

  • Optometrist
  • Ashburn, VA
  • NPI 1104013200
  NPD

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1679615009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 641",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201460641",
            "telephone_number": "703-723-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20600 GORDON PARK SQ",
            "address_2": "SUITE 150",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201473145",
            "telephone_number": "703-723-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEYAM MOJALLAL OD AND ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "MOJALLAL",
        "authorized_official_first_name": "PEYAM",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "703-723-3433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kailynn Olvia Perkins
• Niyha Pernell
• Janet Perrotta, NP
• Alyssa Renae Perry
• Kendra Peters
• Brianna Lynn Phelps
• Hannah E Phillips, M.D.
• Julia Phillips
• Kelly M Phillips, DPT
• Physiotherapy Associates, Inc.

• All providers in Ashburn, VA
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.