Individual provider Active NPI

John William Dresely Jr., O.D.

  • Optometrist
  • Chantilly, VA
National Provider Identifier
1861500852
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000041 Issued in VA
Practice address
3910 Centreville Rd Ste 100
Chantilly, VA 20151-3280
Phone
(703) 830-6380
Fax
(703) 263-2441
NPI assigned
Aug 29, 2006
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000041 VA Primary

Addresses

Primary practice location

3910 Centreville Rd Ste 100
Chantilly, VA 20151-3280

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

14245E Centreville Sq
Centreville, VA 20121-2368
Phone (703) 830-2010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120919000673 VA Practitioner - Optometry 5496903239 Reassigns benefits to 1 organization
I20170504001933 DC Practitioner - Optometry 5496903239 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000041VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Virginia PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Dec 31, 2021 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Dec 31, 2021 Accepting new patients
Myeyedr Optometry of Virginia, PLLC Optometrist CurrentSince Dec 31, 2021 Accepting new patients
Virginia Vision Associates Optometry PLLC Optometrist Past Accepting new patients
Larry N London OD Past Accepting new patients

Locations

44050 Ashburn Shopping Plz
Ste 163
Ashburn, VA 20147
Phone (703) 726-0005

44727 Brimfield Dr
Ashburn, VA 20147
Phone (571) 385-4600

10338 Bristow Center Dr
Bristow, VA 20136
Phone (703) 392-1010

14245P Centreville Sq
Centreville, VA 20121
Phone (703) 830-2010

3910 Centreville Rd
Ste 100
Chantilly, VA 20151
Phone (703) 830-6377

5809 Leesburg Pike
Falls Church, VA 22041
Phone (866) 693-9336

709 Pine St
Herndon, VA 20170
Phone (703) 471-7810

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 7

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1861500852",
    "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",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 CENTREVILLE RD STE 100",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201513280",
            "telephone_number": "703-830-6380",
            "fax_number": "703-263-2441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14245E Centreville Sq",
            "address_purpose": "LOCATION",
            "city": "Centreville",
            "state": "VA",
            "postal_code": "201212368",
            "country_code": "US",
            "telephone_number": "703-830-2010",
            "fax_number": "703-818-7014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRESELY",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chantilly, VA

Sources for this page

Verify at the official NPI Registry.