The Eye Specialists LTD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0101232452 Issued in VA

Legal business name

THE EYE SPECIALISTS LTD

Practice address

813 Independence Blvd
Virginia Beach, VA 23455-6004

Phone

(757) 490-9091

Fax

(757) 490-3250

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Dietrich Albert Fellner, M.D.NPI 1922097179

Title

President

Phone

(757) 490-9091

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: dfellner@theeyespecs.intellechartdirect.net
• Direct secure messaging: ccook@theeyespecs.intellechartdirect.net

Practitioners 4

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

• Dietrich Albert Fellner, M.D.

  • Ophthalmology Physician
  • Virginia Beach, VA
  • NPI 1922097179
  Medicare reassignment Care Compare group NPD Authorized official
• Christine Ware Cook, F.A.A.O

  • Optometrist
  • Virginia Beach, VA
  • NPI 1164411310
  Medicare reassignment Care Compare group NPD
• David Domachowski, O.D.

  • Optometrist
  • Virginia Beach, VA
  • NPI 1588040695
  Medicare reassignment NPD
• Mary Lanier Huntley-Wagner, FNP

  • Family Nurse Practitioner
  • Virginia Beach, VA
  • NPI 1376775098
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1720179104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 INDEPENDENCE BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556004",
            "telephone_number": "757-490-9091",
            "fax_number": "757-490-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 INDEPENDENCE BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556004",
            "telephone_number": "757-490-9091",
            "fax_number": "757-490-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EYE SPECIALISTS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "FELLNER",
        "authorized_official_first_name": "DIETRICH",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-490-9091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000757",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101232452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC CIGNA GOVERNMENT SERVICES",
            "identifier": "0761520001",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010030013",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "110252",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "C30644",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Ophthalmology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.