Eyecare of Vermont, PLC

Organization Active NPI Optometrist · Essex Junction, VT

NPI 1194278978 · NPPES record last updated Jul 28, 2016

Key facts

NPI
1194278978
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
EYECARE OF VERMONT, PLC
Practice address
77 Pearl St
Suite B
Essex Junction, VT 05452-3625
Phone
(802) 878-5509
Fax
(802) 878-0783
NPI assigned
Jul 28, 2016
Organization subpart
No

Authorized official

Name
Penny Brooks
Title
Billing Specialist
Phone
(802) 878-5509

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 5

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eyecare of Vermont PLC
77B Pearl St, Essex Junction, VT 05452-3625 · (802) 878-5509
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignment
Participating since Dec 1, 1999

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930080263 VT DME Supplier - Physician - Optometrist
DME Supplier - Optician
1850316399 1 other NPI on this enrollment
Practice locations: Essex Junction, VT

National Provider Directory

Locations

77B Pearl St
Ste B
Essex Junction, VT 05452
Phone (802) 878-5509

77 Pearl St
#B
Essex Junction, VT 05452
Phone (503) 558-4686

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X VT Yes

Addresses

Primary practice location

77 Pearl St
Suite B
Essex Junction, VT 05452-3625

Mailing address

77 Pearl St
Suite B
Essex Junction, VT 05452-3625
Phone (802) 878-5509

Other providers in Essex Junction, VT

All providers in Essex Junction, VT · Optometrist in Vermont

Sources for this page

Verify at the official NPI Registry.