PAYAL KOTHARI
NPI 1922514314
Optometrist in Fredericksburg, VA

Q: What is Payal Kothari's NPI number?

The NPI number for Payal Kothari is 1922514314. It was assigned to this individual provider in the NPPES registry on December 20, 2017.

Q: What is Payal Kothari's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Payal Kothari was last updated on April 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 20, 2017PECOS EnrolledAccepts Medicare Assignment

927 MAPLE GROVE DR STE 209, FREDERICKSBURG, VA 22407(540) 208-5827(540) 318-7844 Get Directions Write a Review

NPPES record last updated: April 2, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 2, 2026, Apr 3, 2024, Dec 20, 2017 (3 updates tracked since 2017).

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About Payal Kothari NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PAYAL KOTHARI (NPI 1922514314) is an individual optometrist in Fredericksburg, Virginia, licensed in Virginia (0618003607) and active in the NPI registry since December 2017. She is enrolled in Medicare PECOS, is affiliated with Tidalhealth Peninsula Regional, Inc, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1922514314

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NamePAYAL KOTHARI

Location Address927 MAPLE GROVE DR STE 209Fredericksburg, VA 22407-6936

Mailing AddressPo Box 45923Baltimore, MD 21297-5923 · (877) 969-0392 · Fax (804) 658-0582

Phone(540) 208-5827

Fax(540) 318-7844

Sole ProprietorNo

Medical School CMSIllinois College Of Optometry At ChicagoGraduated 2017

Enumeration DateDecember 20, 2017

Last NPPES UpdateApril 2, 20263 updates tracked since enumeration

NPPES CertifiedApril 2, 2026

✔ NPI 1922514314 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

Licenses✔ Licensed in VA · 0618003607✔ Licensed in NY · 008715✔ Licensed in MD · TA2979

Definition

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.

927 MAPLE GROVE DR STE 209, Fredericksburg, VA 22407

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Secondary Practice Locations 2

Location 1101 Milford StSalisbury, MD 21804-6952 · Phone (410) 749-9290 · Fax (410) 543-9087

Location 218460 Crossroad PkwyCulpeper, VA 22701-4112 · Phone (540) 208-5827 · Fax (540) 318-7844

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Payal Kothari is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507266624

PECOS Enrollment IDI20240228002034

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

259 services189 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

230 services230 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

138 services138 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

82 services72 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

76 services73 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

46 services45 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Tidalhealth Peninsula Regional, Inc

Acute Care Hospitals · Salisbury, MD

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number210019

Location100 East Carroll AvenueSalisbury, MD 21801 · Wicomico County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22407 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$129.04 typical visit price

range $56.19 – $170.30

Typical copayment $32.26 (range $14.04 – $42.57)

Most-billed visit code 99204

Established Patient

$70.08 typical visit price

range $18.07 – $138.91

Typical copayment $17.52 (range $4.51 – $34.72)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAUREN LOFDAHL RICHARDS OD

Optometrist

927 MAPLE GROVE DR STE 209
FREDERICKSBURG, VA 22407

Spotsylvania County (540) 208-5827

DR. TIMOTHY LEWIS BRADSHAW O.D.

Optometrist

927 MAPLE GROVE DR STE 209
FREDERICKSBURG, VA 22407

Spotsylvania County (540) 208-5827

DR. BINOY R JANI M.D.

Ophthalmology

927 MAPLE GROVE DR STE 209
FREDERICKSBURG, VA 22407

Spotsylvania County (540) 208-5827

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Payal Kothari's NPI number?

The NPI number for Payal Kothari is 1922514314. It was assigned to this individual provider in the NPPES registry on December 20, 2017.

Where is Payal Kothari located?

Payal Kothari practices at 927 Maple Grove Dr Ste 209, Fredericksburg, VA 22407. The listed phone number is (540) 208-5827.

What is Payal Kothari's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Payal Kothari enrolled in Medicare?

Yes. Payal Kothari is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Payal Kothari accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Providence Health Plan list Payal Kothari as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Payal Kothari affiliated with any hospitals?

According to CMS data, Payal Kothari is affiliated with Tidalhealth Peninsula Regional, Inc.

When was this NPI record last updated?

The NPPES record for Payal Kothari was last updated on April 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.