Organization Active NPI

Nova Advanced Eyecare, PLLC

  • Ophthalmology Physician
  • Centreville, VA
National Provider Identifier
1720780877
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
NOVA ADVANCED EYECARE, PLLC
Practice address
13890 Braddock Rd Ste 302
Centreville, VA 20121-2438
Phone
(571) 832-8650
NPI assigned
Mar 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Authorized official

Name
Dr. Hana NA, MDNPI 1285078295
Title
Owner
Phone
(571) 832-8650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

13890 Braddock Rd Ste 302
Centreville, VA 20121-2438

Mailing address

13890 Braddock Rd Ste 302
Centreville, VA 20121-2438
Phone (571) 832-8650

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230509002488 DC Part B Supplier - Clinic/Group Practice 9234595646 Receives reassigned benefits from 1 practitioner
Practice locations: Centreville, VA
O20231221003625 VA Part B Supplier - Clinic/Group Practice 9234595646 Receives reassigned benefits from 1 practitioner
Practice locations: Haymarket, VA; Manassas, VA

National Provider Directory

National Provider Directory

Locations

13890 Braddock Rd
Ste 302
Centreville, VA 20121
Phone (240) 233-4313

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1720780877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13890 BRADDOCK RD STE 302",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212438",
            "telephone_number": "571-832-8650",
            "fax_number": "571-832-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13890 BRADDOCK RD STE 302",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212438",
            "telephone_number": "571-832-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA ADVANCED EYECARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "NA",
        "authorized_official_first_name": "HANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-832-8650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.