Northern Valley Eyecare, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

328, 140, 263 Issued in VT

Legal business name

NORTHERN VALLEY EYECARE, INC.

Practice address

128 Fisher Pond Rd
Saint Albans, VT 05478-6058

Phone

(802) 524-9561

Fax

(802) 524-6060

NPI assigned

Sep 30, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Greta M. Boulerice

Title

Office Administrator

Phone

(802) 524-9561

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Phillips

  • Optometrist
  • Saint Albans, VT
  • NPI 1427897206
  Medicare reassignment Care Compare group NPD
• Steven John St. Marie, O.D.

  • Optometrist
  • St Albans, VT
  • NPI 1114920170
  Medicare reassignment Care Compare group NPD
• Joseph Philip O'Brien, O.D.

  • Optometrist
  • South Burlington, VT
  • NPI 1285637249
  NPD (past)
• Carl Edward Whitehouse, O.D.

  • Optometrist
  • St Albans, VT
  • NPI 1861495715
  NPD (past)
• Keren H. Yang, O.D.

  • Optometrist
  • Silverdale, WA
  • NPI 1912965906
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1083601587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 FISHER POND RD",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054786058",
            "telephone_number": "802-524-9561",
            "fax_number": "802-524-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 FISHER POND RD",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054786058",
            "telephone_number": "802-524-9561",
            "fax_number": "802-524-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN VALLEY EYECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2022-03-11",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "BOULERICE",
        "authorized_official_first_name": "GRETA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "802-524-9561",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VT",
            "license": "328, 140, 263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010944",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC6158",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH CARE",
            "identifier": "200000905",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "NORT00007939",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah W Nielsen, PT
• Terri Thomas Nielsen, MD
• Raya Noreault, LCMHC
• Paul Norris, PH.D.
• Steven Bruce North
• Northern Vermont Dermatology, PLC
• Northwest Chiropractic PLLC
• Northwest Hearing Services, PC
• Northwest Medical Surgical Associates Inc
• Northwest Radiology Associates P C

• All providers in Saint Albans, VT
• Optometrist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.