Individual provider Active NPI

John Du, O.D.

  • Optometrist
  • Fairfax, VA
National Provider Identifier
1972880755
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002100 Issued in VA
Practice address
10301 New Guinea Rd
Fairfax, VA 22032-3268
Phone
(703) 566-1856
NPI assigned
Nov 8, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618002100 VA Primary

Addresses

Primary practice location

10301 New Guinea Rd
Fairfax, VA 22032-3268

Mailing address

10301 New Guinea Rd
Fairfax, VA 22032-3268

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120809000811 DC Practitioner - Optometry 4284880063 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John Du OD PCGroup PAC ID 5698054146, 2 clinicians

Practice addresses (Care Compare)

10301 New Guinea Rd
Fairfax, VA 22032-3268
Phone (703) 794-5119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
John Du OD PC Optometrist CurrentSince Sep 1, 2016 Accepting new patients
Visual Health Doctors of Optometry Optometrist Past Accepting new patients

Locations

10301 New Guinea Rd
Fairfax, VA 22032
Phone (571) 261-5052

10507 Braddock Rd
Ste B
Fairfax, VA 22032
Phone (571) 470-0112

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": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1972880755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10301 NEW GUINEA RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220323268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 NEW GUINEA RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220323268",
            "telephone_number": "703-566-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DU",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-08",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.