Individual provider Active NPI

Charles Robert Cyr, O.D.

  • Optometrist
  • Williston, VT
National Provider Identifier
1104829100
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
030-0000228 Issued in VT
Practice address
5399 Williston Rd
Ste 102
Williston, VT 05495-5321
Phone
(802) 864-5428
NPI assigned
May 23, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 228 VT
Optometrist 152W00000X 030-0000228 VT Primary

Addresses

Primary practice location

5399 Williston Rd
Ste 102
Williston, VT 05495-5321

Mailing address

380 Poker Hill Rd
Underhill, VT 05489-9610
Phone (802) 899-2105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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

Enrollment IDStateProvider typePAC IDDetails
I20040702001113 VT Practitioner - Optometry 9234116567 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030-0000228VTMDOptometrist
228VTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Vermont LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Vermont LLC Optometrist CurrentSince Dec 11, 2017 Accepting new patients
Myeyedr Optometry of Vermont LLC Optometrist CurrentSince Dec 11, 2017 Accepting new patients
Myeyedr Optometry of West Virginia, PLLC Optometrist Past Accepting new patients

Locations

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

5399 Williston Rd
Williston, VT 05495
Phone (802) 862-1808

5399 Williston Rd
Ste 10
Williston, VT 05495
Phone (802) 864-5428

5399 Williston Rd
Ste 102
Williston, VT 05495
Phone (802) 864-5428

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104829100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 POKER HILL RD",
            "city": "UNDERHILL",
            "state": "VT",
            "postal_code": "054899610",
            "telephone_number": "802-899-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5399 WILLISTON RD",
            "address_2": "STE 102",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054955321",
            "telephone_number": "802-864-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYR",
        "first_name": "CHARLES",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "228",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030-0000228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, VT

Sources for this page

Verify at the official NPI Registry.