Individual provider Active NPI

Sandra Lee Grossett, OD

  • Optometrist
  • Fredericksburg, VA
National Provider Identifier
1780662338
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000263 Issued in VA
Practice address
2527 Cowan Blvd
Fredericksburg, VA 22401-8440
Phone
(540) 369-3482
Fax
(540) 372-9604
NPI assigned
Jan 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000263 VA Primary

Addresses

Primary practice location

2527 Cowan Blvd
Fredericksburg, VA 22401-8440

Mailing address

2527 Cowan Blvd
Fredericksburg, VA 22401-8440
Phone (540) 369-3482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20100203000592 VA Practitioner - Optometry 6204979925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2527 Cowan Blvd
Fredericksburg, VA 22401-8440
Phone (540) 369-3482

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000263VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyes in the 'Burg O.D. PLC Optometrist CurrentSince Jan 2, 2013 Accepting new patients

Locations

2527 Cowan Blvd
Fredericksburg, VA 22401
Phone (540) 369-3482

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1780662338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2527 COWAN BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224018440",
            "telephone_number": "540-369-3482",
            "fax_number": "540-372-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2527 COWAN BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224018440",
            "telephone_number": "540-369-3482",
            "fax_number": "540-372-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSETT",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.