Andrea J Hawryluk, OD

Individual provider Active NPI Optometrist · White River Junction, VT

NPI 1457090052 · NPPES record last updated Mar 25, 2024

Key facts

NPI
1457090052
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
030.0133983 (VT)
Practice address
155 Maple St Ste 1
White River Junction, VT 05001-7029
Phone
(802) 295-3300
NPI assigned
Jun 1, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Optometry
Education
New England College of Optometry, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Junction Eye Center LLC (6 clinicians)
Eyecare for You PC (5 clinicians)

Practice addresses (Care Compare)

155 Maple St
White River Junction, VT 05001-7029
Phone (802) 295-3300

1593 VT Rte
Suite 107
Bethel, VT 05032-4456
Phone (802) 234-9728

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230616001794 VT Practitioner - Optometry 8729446158 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
TUV009543-01NYMDOptometrist
030.0133983VTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare for You, PC Optometrist Current
since Jul 1, 2023
Accepting new patients
Eyecare for You, PC Current
since Jul 1, 2023
Accepting new patients
Junction Eye Center LLC Optometrist Current
since Jul 1, 2023
Accepting new patients
Montrose Vamc Past
since Oct 1, 2023
Accepting new patients

Locations

1593 Vt Rte 107
Bethel, VT 05032
Phone (802) 234-9728

155 Maple St
White River Junction, VT 05001
Phone (802) 295-3300

155 Maple St
Ste 1
White River Junction, VT 05001
Phone (802) 295-3300

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 030.0133983 VT Yes
Optometrist 152W00000X TUV009543-01 NY

Addresses

Primary practice location

155 Maple St Ste 1
White River Junction, VT 05001-7029

Mailing address

155 Maple St Ste 1
White River Junction, VT 05001-7029
Phone (802) 295-3300

Other providers in White River Junction, VT

All providers in White River Junction, VT · Optometrist in Vermont

Sources for this page

Verify at the official NPI Registry.