Individual provider Active NPI

Ana Sofia Domingues, O.D.

  • Optometrist
  • Bethesda, MD
National Provider Identifier
1912191339
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1929 Issued in MD
Practice address
6410 Rockledge Dr
Suite #610
Bethesda, MD 20817-1809
Phone
(301) 896-0890
Fax
(301) 896-0968
NPI assigned
Aug 29, 2007
Last updated
Aug 29, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1929 MD Primary

Addresses

Primary practice location

6410 Rockledge Dr
Suite #610
Bethesda, MD 20817-1809

Mailing address

6410 Rockledge Dr
Suite #610
Bethesda, MD 20817-1809
Phone (301) 896-0890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA1929MDMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188345600000",
    "number": "1912191339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 ROCKLEDGE DR",
            "address_2": "SUITE #610",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171809",
            "telephone_number": "301-896-0890",
            "fax_number": "301-896-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 ROCKLEDGE DR",
            "address_2": "SUITE #610",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171809",
            "telephone_number": "301-896-0890",
            "fax_number": "301-896-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUES",
        "first_name": "ANA",
        "middle_name": "SOFIA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.