Rebecca Lynne Kivlin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002728 Issued in VA

Practice address

3031 Javier Rd Ste 300
Fairfax, VA 22031-4638

Phone

(703) 698-8880

Fax

(703) 698-8884

NPI assigned

Oct 27, 2015

Last updated

Feb 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Optometry

Education

New England College of Optometry, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Norwich Ophthalmology Group PCGroup PAC ID 8820062508, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Norwich Ophthalmology Group, P.C.

  • Ophthalmology Physician
  • Norwich, CT
  • NPI 1447438924
  Medicare reassignment Care Compare group
• Associates in Eyecare Bristow PC

  • Corneal and Contact Management Optometrist
  • Bristow, VA
  • NPI 1972786234
  NPD (past)
• Norwich Ophthalmology Optical

  dba Eye Q Optical

  • Eyewear Supplier
  • Norwich, CT
  • NPI 1427081199

  Optometrist

  NPD (past)
• Ophthalmic Consultants of Connecticut PC

  • Ophthalmology Physician
  • Fairfield, CT
  • NPI 1659319598

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1445904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1811369044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 JAVIER RD STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314638",
            "telephone_number": "703-698-8880",
            "fax_number": "703-698-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 JAVIER RD STE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314638",
            "telephone_number": "703-698-8880",
            "fax_number": "703-698-8884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "179 Flanders Rd Unit 2",
            "address_purpose": "LOCATION",
            "city": "Niantic",
            "state": "CT",
            "postal_code": "063571206",
            "country_code": "US",
            "telephone_number": "860-691-0253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5249 Duke St Ste 5255",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223042926",
            "country_code": "US",
            "telephone_number": "703-823-5205",
            "fax_number": "703-823-9391",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "79 Wawecus St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "06360",
            "country_code": "US",
            "telephone_number": "860-886-0161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIVLIN",
        "first_name": "REBECCA",
        "middle_name": "LYNNE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-27",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002728",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "2963",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly McHale Kisiel, FNP-BC
• Eric William Kisling
• Kismet Psychiatry and Wellness, LLC
• Kissinger Healthcare Enterprises, LLC (Homewatch CareGivers of Fairfax)
• Jack Kitaeff, PH.D.
• Christine M Klam, NP
• Rosemary Klapac Guimond
• Tabitha Kathleen Kleehammer
• Alyssa Kleeman
• David Klein, LCSW

• Optometrist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.