Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Prema Modak, MD

Individual provider Ophthalmology Physician · NPI 1689894578

Dr. Prema Modak, MD is an Ophthalmology in Fairfax, Virginia. Graduated from Rutgers New Jersey Medical School in 2002, 24 years ago. Practices with Eye Specialists and Surgeons of Northern Virginia LLC, an 11-clinician group and accepts Medicare assignment. Licensed in Maryland and Virginia.

Years since qualifying
24
Trained at
Rutgers New Jersey Medical School
Licensed in
MD, VA
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3998 Fair Ridge Dr Ste 105
Fairfax, VA 22033-2980
Phone: (571) 349-2191
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence 0101240540 (VA)
Ophthalmology Physician Taxonomy 207W00000X · Licence D0070139 (MD)

Record details

NPI number1689894578
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 26, 2007
Last updated in NPPESJuly 30, 2019
Mailing address3998 Fair Ridge Dr Ste 105, Fairfax, VA 22033-2980

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPHTHALMOLOGY
Medical schoolRUTGERS NEW JERSEY MEDICAL SCHOOL
Graduated 2002 (24 years in practice)
Group practice Eye Specialists And Surgeons Of Northern Virginia Llc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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