Individual provider Active NPI

Michael John Bermel, O.D.

  • Optometrist
  • Fairfax, VA
National Provider Identifier
1679635460
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0601001101 Issued in VA
Practice address
10640 Main St Ste 100
Fairfax, VA 22030-3930
Phone
(703) 691-2020
Fax
(240) 554-1417
NPI assigned
Dec 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0601001101 VA Primary

Addresses

Primary practice location

10640 Main St Ste 100
Fairfax, VA 22030-3930

Mailing address

7531 Somerset Crossing Dr
Gainesville, VA 20155-4873
Phone (571) 261-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120424000437 DC Practitioner - Optometry 6406018233 Reassigns benefits to 1 organization
I20120514000654 VA Practitioner - Optometry 6406018233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael J. Bermel, O.D., P.C.Group PAC ID 0244492007, 3 clinicians

Practice addresses (Care Compare)

10640 Main St
Suite 100
Fairfax, VA 22030-3930
Phone (703) 691-2020

55 A Catoctin Cir NE
Leesburg, VA 20176-3106
Phone (703) 777-3455

55 Catoctin Cir
Suite a
Leesburg, VA 20176-3106

55 Catoctin Cir NE
Suite a
Leesburg, VA 20176-3106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0601001101VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael J. Bermel, O.D., P.C. Optometrist CurrentSince May 9, 1990 Accepting new patients

Locations

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

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

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

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679635460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7531 SOMERSET CROSSING DR",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201554873",
            "telephone_number": "571-261-5100",
            "fax_number": "240-554-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10640 MAIN ST STE 100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303930",
            "telephone_number": "703-691-2020",
            "fax_number": "240-554-1417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMEL",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601001101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.