Richard A Van de Velde, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001640 Issued in GA

Practice address

3215 Shrine Rd
Suite 6
Brunswick, GA 31520

Phone

(912) 267-0565

Fax

(912) 265-0545

NPI assigned

Aug 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Optometry

Education

Ferris State College - College of Optometry, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John E Imhoff MD PCGroup PAC ID 0749278943, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.11 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

77.04

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: richard.vandevelde.p1@direct.see.nextgenshare.com

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.

• John E Imhoff MD PC

  dba Imhoff Eye Center

  • Ophthalmology Physician
  • Brunswick, GA
  • NPI 1366540007

  Optometrist

  Medicare reassignment Care Compare group NPD
• Florida Retina Institute James a Staman MD LLC

  dba Florida Retina Institute

  • Ophthalmology Physician
  • Orlando, FL
  • NPI 1447328026
  NPD (past)

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1396757480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 SHRINE RD",
            "address_2": "SUITE 6",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31520",
            "telephone_number": "912-267-0565",
            "fax_number": "912-265-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 SHRINE RD",
            "address_2": "SUITE 6",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31520",
            "telephone_number": "912-267-0565",
            "fax_number": "912-265-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DE VELDE",
        "first_name": "RICHARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00912821A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• United Health & Wellness Detox, Inc
• Susana Urgiles, M.D
• Urology Associates, LLP
• Usaccuscreen, LLC
• Brianna Ussery, RDN
• Melody Vasquez, FNP
• Laura Hayley Veal, FNP
• Vision Center of Brunswick, Inc (Vision Center of Brunsiwck)
• Vitas Laboratory LLC
• Kelly Danielle Wagner, PTA

• Optometrist in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.