Alexander Van Dyck, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

030.0133954 Issued in VT

Practice address

5399 Williston Rd Ste 102
Williston, VT 05495-5321

Phone

(802) 864-5428

NPI assigned

Jul 29, 2018

Last updated

Aug 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC, VT, NH4 enrollments

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 4

Specialty

Optometry

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Vermont LLCGroup PAC ID 4486912607, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Myeyedr Optometry of Vermont LLC

  dba MyEyeDr.

  • Optometrist
  • Williston, VT
  • NPI 1295245876
  Medicare reassignment Care Compare group NPD
• Infinite Medical PC

  • Family Medicine Physician
  • Bristol, RI
  • NPI 1407483175

  VT

  Medicare reassignment NPD
• Myeyedr Optometry of Maryland, LLC

  dba MyEyeDr

  • Optometrist
  • Waldorf, MD
  • NPI 1609204437
  Medicare reassignment NPD
• Swift Optometry Care PC

  • Optometrist
  • Tolland, CT
  • NPI 1063753887

  NH, VT

  Medicare reassignment NPD
• Myeyedr Optometry of Vermont LLC

  dba MyEyeDr.

  • Optometrist
  • Burlington, VT
  • NPI 1760075345
  NPD
• Myeyedr Optometry of Maryland, LLC

  dba MyEyeDr.

  • Optometrist
  • Bel Air, MD
  • NPI 1114397908
  NPD
• Myeyedr Optometry of Maryland, LLC

  dba MyEyeDr.

  • Optometrist
  • Laurel, MD
  • NPI 1972900058
  NPD
• Myeyedr Optometry of West Virginia, PLLC

  dba MyEyeDr.

  • Optometrist
  • Charles Town, WV
  • NPI 1639528946
  NPD (past)

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

{
    "created_epoch": "1532822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1154809507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5399 WILLISTON RD STE 102",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054955321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5399 WILLISTON RD STE 102",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054955321",
            "telephone_number": "802-864-5428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Division Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112117307",
            "country_code": "US",
            "telephone_number": "718-964-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DYCK",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-29",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2649",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002803",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030.0133954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Turner
• Monika B Turner, LCMHC
• Cheryl Underwood, FNP
• United Seating and Mobility, LLC (Numotion)
• University of Vermont Medical Center Inc (University of Vermont Medical Center Outpatient Pharmacy)
• Kristiana Vanderhoof, D.P.T.
• Elisa Vautier, RN
• Vermont Center for Regenerative Medicine (Lake Champlain Regen Medical)
• Vermont Counseling LLC
• Vermont CVS Pharmacy LLC (CVS Pharmacy # 07103)

• Optometrist in Williston, VT
• Providers in Williston, VT by specialty
• Optometrist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.