Individual provider Active NPI

Jorge Luis Campana, M.D.

  • Ophthalmology Physician
  • Falls Church, VA
National Provider Identifier
1811981483
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101043415 Issued in VA
Practice address
6201 Leesburg Pike
Suite 200
Falls Church, VA 22044-2201
Phone
(703) 534-4277
Fax
(703) 241-5510
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0101043415 VA Primary

Addresses

Primary practice location

6201 Leesburg Pike
Suite 200
Falls Church, VA 22044-2201

Mailing address

6201 Leesburg Pike
Suite 200
Falls Church, VA 22044-2201
Phone (703) 534-4277

Other identifiers 1

IdentifierTypeStateIssuer
006301576MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091124000309 DC Practitioner - Ophthalmology 6901989524 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101043415VAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eyedata - Eye Doctors and Technology Advantage Ophthalmology CurrentSince Nov 1, 2019 Accepting new patients

Locations

410 S Washington St
Falls Church, VA 22046
Phone (703) 532-0728

Organizations & group practices 2

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1811981483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 LEESBURG PIKE",
            "address_2": "SUITE 200",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220442201",
            "telephone_number": "703-534-4277",
            "fax_number": "703-241-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 LEESBURG PIKE",
            "address_2": "SUITE 200",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220442201",
            "telephone_number": "703-534-4277",
            "fax_number": "703-241-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPANA",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101043415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006301576",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

Verify at the official NPI Registry.