Renata B. Raeder, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000741 Issued in VA

Practice address

21475 Ridgetop Circle Suite 300
Sterling, VA 20166-8580

Phone

(703) 430-4400

Fax

(703) 430-4130

NPI assigned

Oct 19, 2006

Last updated

Apr 9, 2024By the provider in NPPES

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 6

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Loudoun Medical Group, PC

  dba Urogynecology Center of Northern Virginia

  • Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
  • Reston, VA
  • NPI 1407908817

  DC

  Medicare reassignment NPD
• Loudoun Medical Group, PC

  • Internal Medicine Physician
  • Leesburg, VA
  • NPI 1679591440
  Medicare reassignment NPD
• Northern Virginia Vision Center, Inc.

  dba The Eye Center

  • Optometrist
  • Sterling, VA
  • NPI 1710069950
  Medicare reassignment
• Loudoun Medical Group, PC

  dba Loudoun Medical Group, PC 'D'

  • Vascular Surgery Physician
  • Reston, VA
  • NPI 1588376321
  NPD

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1699857003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 D CORNWALL STREET NW",
            "address_2": "STE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21475 RIDGETOP CIRCLE SUITE 300",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201668580",
            "telephone_number": "703-430-4400",
            "fax_number": "703-430-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAEDER",
        "first_name": "RENATA",
        "middle_name": "B.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1651005-01",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699857003",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1651005-02",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1651005-00",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30015392870001",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1651005-03",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Furhan Rashid Qureshi, MD
• Tala Qutachi
• Arthur Edward Rabenhorst, MD
• Alison Rachuba, LPC
• Shahla Radfar Khani
• Rahel G. Yirga MD PC
• Veena Railan, MD
• Briana Rajakone
• Devanhalli Ramaswamy, M.D.
• Diane Ramia

• Optometrist in Sterling, VA
• Providers in Sterling, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.