DR. TEWODROS GEDAMU (O.D.) – Optometrist, NPI 1558472878

DR. TEWODROS GEDAMU (O.D.) is a healthcare provider. based in Reston, Virginia. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. TA 1661 (MD). The NPI Number for DR. TEWODROS GEDAMU (O.D.) is 1558472878

Main info

Male
Sole Proprietor
26 Years Of Experience
Accepts Medicare Assignment
Name
DR. TEWODROS GEDAMU (O.D.)
NPI
1558472878
Phone
(703) 591-9377
Address
11654 PLAZA AMERICA DR
Enumeration Date
31 August 2006
Last Update Date
21 June 2014

Doctor Profile

Medical School Name
PENNSYLVANIA COLLEGE OF OPTOMETRY
Secondary Phone
7035919377
Graduation Year
2000 (26 years ago)
PAC ID
3072524701
Professional Enrollment ID
I20080508000675
Address ID
VA220333311FA11784HWYX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience70
Completeness75
Years active:19State licenses:3Digital endpointsOther names

1,052 OPTOMETRY in VA

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Provider Addresses for DR. TEWODROS GEDAMU (O.D.)

  • 11654, Plaza America Drive, Plaza America, Sunset Hills, Reston, Fairfax County, Virginia, 20190, United States

    SUITE 194

    RESTON, VA 201904700

    Phone: (703) 591-9377

    Fax: (703) 352-8709

    Type: Mailing

  • 11784, Lee Jackson Memorial Highway, Fairfax Farms, Fair Oaks, Fairfax (city), Virginia, 22033, United States

    FAIROAKS MALL LOWER LEVEL

    FAIRFAX, VA 22033

    Phone: (703) 591-9377

    Fax: (703) 352-8709

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $37.

Total Amount is formed as General ($37) + Research ($0) + Ownership ($0) = $37.

Last reported payment date: 2024-02-13 • Largest payer in this snapshot: RxSight Inc ($37).

Total Amount

$37

General + Research + Ownership

Payments

1

Total payment records

General Amount

$37

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-13

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
RxSight Inc$37
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-05-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080508000675IOptometryDCTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92250Photography of the retina3939$0
99213Established patient office or other outpatient visit, 20-29 minutes3029$0
99203New patient office or other outpatient visit, 30-44 minutes2727$0
View full utilization report →

Insurance plans in this area (ZIP 20190)

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Reviews

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Frequently asked questions

What number should I use to identify DR. TEWODROS GEDAMU (O.D.) for billing?
Administrative and clinical systems typically use NPI 1558472878 for DR. TEWODROS GEDAMU (O.D.).
Should I treat DR. TEWODROS GEDAMU (O.D.) as an active provider?
Patients and plans typically see DR. TEWODROS GEDAMU (O.D.) as active in the national extract.
What does the directory say DR. TEWODROS GEDAMU (O.D.) does?
Insurance directories may phrase it differently, but here DR. TEWODROS GEDAMU (O.D.) maps to Optometrist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. TEWODROS GEDAMU (O.D.)?
DR. TEWODROS GEDAMU (O.D.) is associated with Reston, Virginia in the same public data insurers reference.
Who maintains DR. TEWODROS GEDAMU (O.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.