FAIRFAX EYE CENTER, PC (NPI# 1205024692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205024692 |
| Entity Type | Organization |
| Organization Name | FAIRFAX EYE CENTER, PC |
| Practice Address |
3650 Joseph Siewick Dr Ste 303 Fairfax VA 22033-1714 |
| Mailing Address |
2916 Hibbard St Oakton VA 22124-2648 |
| Practice Telephone | 5088015833 |
| Practice Fax Number | 7032420919 |
| Mailing Telephone | 5088015833 |
| Mailing Fax Number | 7032420919 |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2007-10-10 |
| Authorized Official Name | DR. HEATHER DIANNE HARTZELL (PRESIDENT AND OWNER) |
| Authorized Official Telephone | 5088015833 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 0101239520 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICARE PTAN | 492195 | 01 |
| Street Address |
3650 JOSEPH SIEWICK DR STE 303 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22033-1714 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366074320 | Han S Yoo | Pharmacist | 12200 West Ox Road, Fairfax, VA 22033 | 2020-02-07 |
| 1386137271 | Ammar Orthodontics Pllc | Dentist | 11702 Fiar Oaks Mall, Upper Floor, Fairfax, VA 22033 | 2018-06-14 |
| 1013360940 | Kellyn Patricia Dodd | Nurse Practitioner | 3903 Fair Ridge Dr Ste 209, Fairfax, VA 22033 | 2016-07-15 |
| 1659721363 | John Du Od PC | Optometrist | 12618 Victoria Station Ct, Fairfax, VA 22033 | 2016-06-14 |
| 1568861904 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12734 Shoppes Lane, Fairfax, VA 22033 | 2014-08-21 |
| 1649696295 | Patrisha Lultschik | Nurse Practitioner | 12375 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2014-03-06 |
| 1912321910 | Alyson Huber | Nurse Anesthetist, Certified Registered | 3600 Joseph Siewick Dr., Fairfax, VA 22033 | 2014-02-11 |
| 1578999314 | Aiatulah Surmaty | Optometrist | 11801 Lee Jackson Memorial Hwy, Fairfax, VA 22033 | 2013-09-25 |
| 1356780928 | Ayatallah M. Khafagy | Obstetrics & Gynecology | 3650 Joseph Siewick Dr Suite 203, Fairfax, VA 22033 | 2013-06-17 |
| 1760726665 | Michelle Elise Schwartz | Speech-Language Pathologist | 3507 Curtice Farm Dr, Fairfax, VA 22033 | 2012-11-15 |
| Find all providers in zip 22033 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649619305 | Northern Virginia Eye Physicians, PC | Ophthalmology | 10721 Main St Ste 3200, Fairfax, VA 22030-6906 | 2013-06-17 |
| 1689894578 | Prema Modak | Ophthalmology | 3998 Fair Ridge Dr Ste 105, Fairfax, VA 22033-2980 | 2007-04-26 |
| 1376766816 | John Phillip Essepian IIi | Ophthalmology | 3031 Javier Rd Ste 300, Fairfax, VA 22031-4638 | 2007-04-11 |
| 1750427555 | John Robert Minarcik Jr. | Ophthalmology | 8505 Arlington Blvd Ste 300, Fairfax, VA 22031-4630 | 2007-01-29 |
| 1881663102 | Fairfax Eye Associates Inc | Ophthalmology | 9936 Main St, Fairfax, VA 22031 | 2006-03-17 |
| 1407824394 | Jacqueline Jiang Fredrick | Ophthalmology | 12011 Lee Jackson Mem Hwy #305, Fairfax, VA 22033 | 2006-03-08 |
| 1003814534 | David Benjamin Summer | Ophthalmology | 3031 Javier Rd, Suite 300, Fairfax, VA 22031-4637 | 2005-07-08 |
| 1982067112 | Meghan Giurintano Moroux | Ophthalmology | 3998 Fair Ridge Dr Ste 105, Fairfax, VA 22033-2980 | 2016-04-04 |
| 1275904674 | Eye Specialists and Surgeons of Northern Virginia, LLC | Ophthalmology | 3998 Fair Ridge Dr Ste 105, Fairfax, VA 22033-2980 | 2015-10-12 |
| 1861889008 | Loudoun Medical Group PC | Ophthalmology | 8316 Arlington Blvd, Suite 235, Fairfax, VA 22031-5207 | 2015-04-24 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.