Organization Active NPI

Acuity Vision Care PC

  • Optometrist
  • Ashburn, VA
National Provider Identifier
1871634675
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001051 Issued in VA
Legal business name
ACUITY VISION CARE PC
Practice address
20600 Gordon Park SQ
Suite 150
Ashburn, VA 20147-3145
Phone
(703) 723-3433
NPI assigned
Feb 12, 2007
Last updated
Jan 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Authorized official

Name
Dr. Peyam Mojallal, ODNPI 1154378511
Title
President Owner
Phone
(703) 723-3433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001051 VA Primary

Addresses

Primary practice location

20600 Gordon Park SQ
Suite 150
Ashburn, VA 20147-3145

Mailing address

20600 Gordon Park SQ
Suite 150
Ashburn, VA 20147-3145
Phone (703) 723-3433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101124000964 VA Part B Supplier - Clinic/Group Practice 0547469710 Receives reassigned benefits from 2 practitioners
Practice locations: Ashburn, VA

National Provider Directory

National Provider Directory

Locations

20600 Gordon Park Sq
Ste 150
Ashburn, VA 20147
Phone (703) 723-3433

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1871634675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20600 GORDON PARK SQ",
            "address_2": "SUITE 150",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201473145",
            "telephone_number": "703-723-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20600 GORDON PARK SQ",
            "address_2": "SUITE 150",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201473145",
            "telephone_number": "703-723-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACUITY VISION CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "MOJALLAL",
        "authorized_official_first_name": "PEYAM",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "703-723-3433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.