Individual provider Active NPI

Tanisha Perlmutter, OD

  • Optometrist
  • Marion, VA
National Provider Identifier
1427890284
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618003410 Issued in VA
Practice address
1020 Terrace Dr Ste 100
Marion, VA 24354-4392
Phone
(276) 783-5157
Fax
(276) 783-5159
NPI assigned
Jun 11, 2024
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618003410 VA Primary

Addresses

Primary practice location

1020 Terrace Dr Ste 100
Marion, VA 24354-4392

Mailing address

1020 Terrace Dr Ste 100
Marion, VA 24354-4392
Phone (276) 783-5157

Other practice location 1

699 McBroom St NW Ste A
Abingdon, VA 24210-2590
Phone (276) 628-1143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TN2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20241018003854 VA Practitioner - Optometry 3375075070 Reassigns benefits to 1 organization
I20241219000855 TN Practitioner - Optometry 3375075070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Envision Professional Group PLLCGroup PAC ID 5799040184, 11 clinicians

Practice addresses (Care Compare)

1020 Terrace Dr
Suite 100
Marion, VA 24354-4392
Phone (276) 783-5157

321 Midway Medical Park
Suite 2
Bristol, TN 37620-1652
Phone (276) 783-5157

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Professional Group, PLLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

321 Midway Medical Park
Ste 2
Bristol, TN 37620
Phone (276) 783-5157

2549 W State St
Bristol, TN 37620

122 Old Gray Station Rd
Ste A
Johnson City, TN 37615

122 Old Gray Station Rd
Johnson City, TN 37615
Phone (276) 783-5157

699 McBroom St NW
Abingdon, VA 24210
Phone (276) 628-1134

699 McBroom St NW
Ste A
Abingdon, VA 24210
Phone (276) 628-1143

1020 Terrace Dr
Ste 100
Marion, VA 24354
Phone (276) 783-5157

Interoperability endpoints

  • Direct secure messaging: tperl@envisioneyeva.emadirect.md

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": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1427890284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 TERRACE DR STE 100",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243544392",
            "telephone_number": "276-783-5157",
            "fax_number": "276-783-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 TERRACE DR STE 100",
            "city": "MARION",
            "state": "VA",
            "postal_code": "243544392",
            "telephone_number": "276-783-5157",
            "fax_number": "276-783-5159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "699 McBroom St NW Ste A",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242102590",
            "country_code": "US",
            "telephone_number": "276-628-1143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERLMUTTER",
        "first_name": "TANISHA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618003410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, VA

Sources for this page

Verify at the official NPI Registry.