Tanya Marie Vigdal, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG003789 Issued in PA

Practice address

841 E Baltimore Pike
Kennett Square, PA 19348-1801

Phone

(610) 444-5252

NPI assigned

May 20, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Pennsylvania LLCGroup PAC ID 3971884883, 118 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles (3 of 6)

Locations

Networks

• devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
• devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
• devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Myeyedr Optometry of Pennsylvania, LLC

  • Optometrist
  • Carlisle, PA
  • NPI 1003264607
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Pennsylvania, LLC

  • Optometrist
  • Cranberry Township, PA
  • NPI 1093688491
  NPD
• Myeyedr Optometry of Pennsylvania, LLC

  • Optometrist
  • Upper Chichester, PA
  • NPI 1417502220
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1003481391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 E BALTIMORE PIKE",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481801",
            "telephone_number": "610-444-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGDAL",
        "first_name": "TANYA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Jo Valencia, OTR/L
• James Michael Valentino
• Susan E. Vanore
• Jennifer Vattimo, R.D.
• Alma Chicote Vertudazo, OTR
• Katie Marie Voorhees, COTA
• Anita F Wagner, LPT
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co

• Optometrist in Kennett Square, PA
• Providers in Kennett Square, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.