ELAINE P. BOURDEAU (NPI# 1164503876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164503876 |
| Entity Type | Individual |
| Full Name | ELAINE P. BOURDEAU |
| Credential | O.D. |
| Practice Address |
19441 Golf Vista Plz Suite 320 Lansdowne VA 20176-8269 |
| Practice Telephone | 7038589800 |
| Practice Fax Number | 7038589801 |
| Mailing Telephone | 7038589800 |
| Mailing Fax Number | 7038589801 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2016-11-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 0618-000960 | VA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 9235990 | 05 | |
| MD | 3461033-01 | 05 | |
| MD | 3461033-03 | 05 | |
| VA | 9235981 | 05 | |
| VA | ANTHEM BCBS/HEALTHKEEPERS | 119168 | 01 |
| VA | ANTHEM BCBS/HEALTHKEEPERS | 119170 | 01 |
| VA | 9235973 | 05 | |
| VA | 9235957 | 05 | |
| VA | ANTHEM BCBS/HEALTHKEEPERS | 119169 | 01 |
| MD | 3461033-00 | 05 | |
| MD | 3461033-2 | 05 | |
| VA | ANTHEM BCBS/HEALTHKEEPERS | 119171 | 01 |
| Street Address |
19441 GOLF VISTA PLZ SUITE 320 |
| City | LANSDOWNE |
| State | VA |
| Zip Code | 20176-8269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205856515 | Barry R Maharaj | Dentist | 19441 Golf Vista Plz, Suite 130, Lansdowne, VA 20176-8269 | 2006-07-20 |
| 1700320249 | Chelsey Brooks | Counselor | 19441 Golf Vista Plz, Suite 110, Lansdowne, VA 20176-8269 | 2016-12-16 |
| 1144634155 | Loudoun Counseling, LLC | Community/Behavioral Health | 19441 Golf Vista Plz, Suite 110, Lansdowne, VA 20176-8269 | 2014-06-17 |
| 1609204163 | Virginia Eye Center, PC | Ophthalmology | 19441 Golf Vista Plz, Suite 210, Lansdowne, VA 20176-8269 | 2013-10-21 |
| 1811206204 | Kathleen Waggoner Petty | Counselor | 19441 Golf Vista Plz, Suite 110, Lansdowne, VA 20176-8269 | 2010-10-01 |
| 1023325404 | Sleep Diagnostic Center Inc | Clinic/Center | 19441 Golf Vista Plz, Ste 310, Lansdowne, VA 20176-8269 | 2010-09-08 |
| 1700190253 | Maryam Kathrine Arena | Psychologist | 19441 Golf Vista Plz, Lansdowne, VA 20176-8269 | 2010-07-27 |
| 1376771089 | Laura M Fawcett | Physical Therapist | 19441 Golf Vista Plz, Suite 230, Lansdowne, VA 20176-8269 | 2009-07-01 |
| 1811149784 | Comprehensive Sleep Care Center Inc | Internal Medicine | 19441 Golf Vista Plz, 310, Lansdowne, VA 20176-8269 | 2008-10-22 |
| 1598815524 | Kristen Lundberg Birkland | Marriage & Family Therapist | 19441 Golf Vista Plz, Suite 110, Lansdowne, VA 20176-8269 | 2007-01-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912923 | Timothy Michael Nixon | Pharmacist | 61 Catoctin Circle, Leesburg, VA 20176 | 2020-11-05 |
| 1558996645 | Stacey E Moran | Occupational Therapist | 44124 Woodrige Parkway, Lansdowne, VA 20176 | 2020-03-09 |
| 1710531272 | Joseph H Kasuska Jr. | Specialist/Technologist | 19455 Deerfield Ave. Suite 306, Lansdowne, VA 20176 | 2019-08-01 |
| 1568935849 | Joel Manalang Polintan Jr. | Physical Therapist | 171 Cedarwalk Circle, Leesburg, VA 20176 | 2019-01-09 |
| 1194203026 | Jing Cao | Acupuncturist | 19450 Deerfield Ave Ste 275, Leesburg, VA 20176 | 2018-08-02 |
| 1134648314 | Alaina Marie Gotwalt | Speech-Language Pathologist | 43850 Heatherstone Terrace, Unit 406, Leesburg, VA 20176 | 2017-09-19 |
| 1841717105 | Happy Inhome Care Corp | Respite Care | 722 E Market St Ste 103, Leesburg, VA 20176 | 2017-08-28 |
| 1912423484 | Aaa Good Healthcare LLC | Nursing Care | 722 East Market Street Ne, Suite 102, Leesburg, VA 20176 | 2017-08-16 |
| 1740704253 | Anna Maria Domingo Seaford | Physician Assistant | 19441 Golf Vista Plz Ste 230, Lansdowne, VA 20176 | 2017-07-27 |
| 1710436480 | Reena Patel | Physician Assistant | 224 Cornwall St Nw Leesburg Orthope, Unit 204, Leesburg, VA 20176 | 2016-09-23 |
| Find all providers in zip 20176 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376563148 | Lansdowne Optometric Associates | Optometrist | 20 E Baltimore Ave, Lansdowne, PA 19050-2202 | 2006-07-21 |
| 1790134807 | William Reid Moughon | Optometrist | 19415 Deerfield Ave, Suite 106, Lansdowne, VA 20176-8452 | 2016-06-09 |
| 1821346438 | Kate Sciorra | Optometrist | 19441 Golf Vista Plaza, Suite 320, Lansdowne, VA 20176 | 2012-08-29 |
| 1740594290 | Lucy S. Lee, O.d., P.l.l.c. | Optometrist | 19369 Promenade Dr, Suite K102, Lansdowne, VA 20176-6501 | 2010-07-27 |
| 1861552721 | Kaiser Foundation Health Plan of The Mid Atlantic States,inc | Optometrist | 19450 Deerfield Avenue, Lansdowne, VA 20176-6821 | 2006-12-11 |
| 1902829518 | Michael B Maizel | Optometrist | 20 E Baltimore Ave, Lansdowne, PA 19050-2202 | 2006-07-25 |
| 1144289661 | Dulles Eye Associates | Optometrist | 19415 Deerfield Ave, Ste 106, Lansdowne, VA 20176-8452 | 2006-03-22 |
| 1811965981 | Leyla Najafi | Optometrist | 19415 Deerfield Ave, Suite 106, Lansdowne, VA 20176-8470 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710124 | Ryan Henger | Optometrist | 12551 Jefferson Ave Ste 249, Newport News, VA 23602-4487 | 2020-11-04 |
| 1457977050 | Carl Brandon Myers | Optometrist | 8125 Timberlake Rd, Lynchburg, VA 24502-2607 | 2020-06-19 |
| 1942826565 | Kendall Shafran | Optometrist | 44365 Premier Plz Ste 210, Ashburn, VA 20147-5058 | 2020-06-19 |
| 1033733258 | Emily Scannell | Optometrist | 1560 Mall Dr, Norfolk, VA 23511-3806 | 2020-06-03 |
| 1962024711 | Nova Optique and Eyecare | Optometrist | 672 N Glebe Rd, Arlington, VA 22203-2161 | 2020-05-15 |
| 1891323101 | Sharpvue Eyecare Pllc | Optometrist | 15243 Forest Rd Ste E, Forest, VA 24551-4974 | 2020-03-31 |
| 1871123943 | Lois Hermann Phillips | Optometrist | 9 Gamebird Ct, Manakin Sabot, VA 23103 | 2020-01-17 |
| 1356991830 | Finpax | Optometrist | 11847 Aspengraf Ln Ste A, New Kent, VA 23124-2130 | 2019-09-16 |
| 1629627559 | Seth Gorman | Optometrist | 4501 S Laburnum Ave Ste 145, Richmond, VA 23231-2483 | 2019-09-04 |
| 1679121800 | George Z Ishak | Optometrist | 1871 Carl D Silver Pkwy Ste 1113, Fredericksburg, VA 22401-4969 | 2019-08-30 |
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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.