Individual provider Active NPI

Samantha Morgan Kayser, OD

  • Optometrist
  • Charlottesville, VA
National Provider Identifier
1730699943
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
618002684 Issued in VA
Practice address
600 Peter Jefferson Pkwy
Charlottesville, VA 22911-8835
Phone
(434) 975-2420
Fax
(434) 975-0200
NPI assigned
Oct 3, 2017
Last updated
Dec 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 618002684 VA Primary

Addresses

Primary practice location

600 Peter Jefferson Pkwy
Charlottesville, VA 22911-8835

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180213002333 FL Practitioner - Optometry 4385904390 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
618002684VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University CurrentSince Jan 19, 2018 Accepting new patients
Nova Southeastern University, Inc Optometrist Current Accepting new patients
Nova Southeastern University Inc. CurrentSince Jan 19, 2018 Accepting new patients

Locations

3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250

1111 W Broward Blvd
Ft Lauderdale, FL 33312
Phone (954) 463-7313

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000

Organizations & group practices 3

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": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1730699943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PETER JEFFERSON PKWY",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118835",
            "telephone_number": "434-975-2420",
            "fax_number": "434-975-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYSER",
        "first_name": "SAMANTHA",
        "middle_name": "MORGAN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "618002684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.