IndividualActiveAccepts Medicare
Michael Kim, OD
NPI 1215525829 · Optometrist · Stone Ridge, VA
Enrolled with Medicare as Practitioner - Optometry · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1215525829
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- License
- 0618002949 (VA)
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
42015 Village Center Plz Ste 103
Stone Ridge, VA 20105-3031
Phone: (703) 542-8888
Approximate (ZIP-level) locationGet directions
Mailing address
12640 Magna Carta Rd
Herndon, VA 20171-2709
Registry dates
- Enumerated
- 2021-01-08
- Last updated
- 2021-01-08
- Certified
- 2021-01-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.