Renata B Raeder, OD | |
21475 Ridgetop Circle Suite 300, Sterling, VA 20166-8580 | |
(703) 430-4400 | |
(703) 430-4130 |
Full Name | Renata B Raeder |
---|---|
Gender | Female |
Speciality | Optometrist |
Location | 21475 Ridgetop Circle Suite 300, Sterling, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699857003 | NPI | - | NPPES |
1699857003 | Medicaid | VA | |
1651005-03 | Medicaid | MD | |
30015392870001 | Medicaid | VA | |
1651005-01 | Medicaid | MD | |
1651005-00 | Medicaid | MD | |
1651005-02 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 0618000741 (Virginia) | Primary |
Provider Name | Loudoun Medical Group, Pc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1407908817 PECOS PAC ID: 0042119661 Enrollment ID: O20040102000616 |
Mailing Address | Practice Location Address |
---|---|
Renata B Raeder, OD 224 D Cornwall Street Nw, Ste 403, Leesburg, VA 20176-2704 Ph: (703) 737-6010 | Renata B Raeder, OD 21475 Ridgetop Circle Suite 300, Sterling, VA 20166-8580 Ph: (703) 430-4400 |
Dr. Joanna Barnett & Associates Inc Optometrist Medicare: Medicare Enrolled Practice Location: 21100 Dulles Town Cir Ste 297, Sterling, VA 20166 Phone: 703-655-1634 Fax: 703-766-1493 | |
Russell B. Pearlman, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 21475 Ridgetop Circle Suite 300, Sterling, VA 20166 Phone: 703-430-4400 Fax: 703-430-4130 | |
Houriya Mahboobi, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 21475 Ridgetop Circle Suite 300, Sterling, VA 20166 Phone: 703-430-4400 Fax: 703-430-4130 | |
Miss Michelle Moinifar, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 24570 Dulles Landing Dr Unit 170, Sterling, VA 20166 Phone: 571-367-7610 Fax: 571-367-7620 | |
Nazanin Latifi, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 165 Seneca Ridge Dr, Sterling, VA 20164 Phone: 703-774-6380 | |
Vivian Vuong, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 20789 Great Falls Plz Ste 108, Sterling, VA 20165 Phone: 571-375-7950 | |
Deena Tailor, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 21475 Ridgetop Cir Ste 300, Sterling, VA 20166 Phone: 703-430-4400 |