Individual provider Active NPI

Pamela Dawn Lundberg, O.D.

  • Optometrist
  • Williamsburg, VA
National Provider Identifier
1215012679
Registry record updated Dec 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000270 Issued in VA
Practice address
101 Bulifants Blvd
Suite a
Williamsburg, VA 23188-5709
Phone
(757) 564-1907
Fax
(757) 564-1913
NPI assigned
Oct 26, 2006
Last updated
Dec 6, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000270 VA Primary

Addresses

Primary practice location

101 Bulifants Blvd
Suite a
Williamsburg, VA 23188-5709

Mailing address

101 Bulifants Blvd
Suite a
Williamsburg, VA 23188-5709
Phone (757) 564-1907

Other identifiers 1

IdentifierTypeStateIssuer
009230491MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20100826000455 VA Practitioner - Optometry 3375443963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRS. Lundberg and Lodwick, Optometrists PCGroup PAC ID 1658271234, 3 clinicians

Practice addresses (Care Compare)

101 Bulifants Blvd
Williamsbirg, VA 23188-5721
Phone (757) 564-1907

Merit-based Incentive Payment System (MIPS)

Final score
35.26 of 100Reported as individual
Quality
70.52
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618000270VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Lundberg and Lodwick, Optometrists PC Optometrist CurrentSince Feb 1, 1994 Accepting new patients

Locations

101 Bulifants Blvd
Ste A
Williamsburg, VA 23188
Phone (757) 564-1907

Organizations & group practices 1

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260057600000",
    "number": "1215012679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BULIFANTS BLVD",
            "address_2": "SUITE A",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885709",
            "telephone_number": "757-564-1907",
            "fax_number": "757-564-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BULIFANTS BLVD",
            "address_2": "SUITE A",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885709",
            "telephone_number": "757-564-1907",
            "fax_number": "757-564-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDBERG",
        "first_name": "PAMELA",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2009-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009230491",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.