MEDICARE: ACCESS EYE CENTERS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier
2	152W00000X	Optometrist
3	156FX1800X	Optician
4	207W00000X	Ophthalmology Physician	0101840394	VA

General Provider Information

NPI Number	:	1578741278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS EYE CENTERS, INC.

Provider Business Mailing Address
First Line	:	110 CAMBRIDGE ST
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22405-1924
Country	:	US
Telephone Number	:	540-371-2020
Fax Number	:	540-373-0141

Provider Business Practice Location Address
First Line	:	4701 SPOTSYLVANIA PARKWAY
Second Line	:	STE #110
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-9434
Country	:	US
Telephone Number	:	540-371-2020
Fax Number	:	540-373-0141

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	ARASH MANSOURI
Credential	:	M.D.
Telephone Number	:	540-371-2020

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	04/30/2025

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