Organization Active NPI

Kian M Kaz MD Eye Physician & Surgeon PC

  • Ophthalmology Physician
  • Newport News, VA
National Provider Identifier
1902899255
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0101058286 Issued in VA
Legal business name
KIAN M KAZ MD EYE PHYSICIAN & SURGEON PC
Practice address
12690 McManus Blvd
Newport News, VA 23602-4433
Phone
(757) 875-7700
Fax
(757) 875-7721
NPI assigned
Aug 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Authorized official

Name
Dr. Kian Monica Kaz, MDNPI 1588657837
Title
Owner/President
Phone
(757) 875-7700

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 0101058286 VA Primary

Addresses

Primary practice location

12690 McManus Blvd
Newport News, VA 23602-4433

Mailing address

12690 McManus Blvd
Newport News, VA 23602-4433
Phone (757) 875-7700

Other identifiers 5

IdentifierTypeStateIssuer
006305750MedicaidVA
464665OtherVAMAMSI
026179OtherVACIGNA
117671OtherVAANTHEM BCBS
52357OtherVAOPTIMA HEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050827000146 VA Part B Supplier - Clinic/Group Practice 7113958323 Receives reassigned benefits from 1 practitioner
Practice locations: Newport News, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1902899255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12690 MCMANUS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024433",
            "telephone_number": "757-875-7700",
            "fax_number": "757-875-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12690 MCMANUS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024433",
            "telephone_number": "757-875-7700",
            "fax_number": "757-875-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIAN M KAZ MD EYE PHYSICIAN & SURGEON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "KAZ",
        "authorized_official_first_name": "KIAN",
        "authorized_official_middle_name": "MONICA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "757-875-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101058286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006305750",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "464665",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "026179",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "117671",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH",
            "identifier": "52357",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.