Amir Ahmadi, OD
Individual provider Active NPI Optometrist · Falls Church, VA
NPI 1710069901 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1710069901
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- TA1846 (MD)
- Practice address
- 3556A S Jefferson St
Falls Church, VA 22041-3119 - Phone
- (703) 379-1100
- Fax
- (703) 379-7617
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040717000115 | DC | Practitioner - Optometry | 0143210252 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TA1846 | MD | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daniel Poth, O.D. and Associates, P.C. | Optometrist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TA1846 | MD | Yes |
Addresses
Primary practice location
3556A S Jefferson St
Falls Church, VA 22041-3119
Mailing address
11103 West Ave
Suite 6
San Antonio, TX 78213-1370
Phone (210) 524-6509
Other providers in Falls Church, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.