NPIMap

Organization Active NPI

Vistar Eye Center, Inc

  • Specialist
  • Roanoke, VA
National Provider Identifier
1457323545
Registry record updated May 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
VISTAR EYE CENTER, INC
Practice address
707 S Jefferson St
Roanoke, VA 24016-5100
Phone
(540) 855-5139
Fax
(540) 342-4373
NPI assigned
Feb 3, 2006
Last updated
May 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2015

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

Authorized official

Name
Mr. Paul Levy
Title
Administrator
Phone
(540) 855-5123

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary
Eyewear Supplier 332H00000X NU

Addresses

Primary practice location

707 S Jefferson St
Roanoke, VA 24016-5100

Mailing address

PO Box 1789
Roanoke, VA 24008-1789
Phone (540) 855-5139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040511001643 VA Part B Supplier - Clinic/Group Practice 0446249858 Receives reassigned benefits from 29 practitioners
Practice locations: Pearisburg, VA; Pulaski, VA; Roanoke, VA; Salem, VA; Staurt, VA; Wytheville, VA; Martinsville, VA; Lexington, VA…
O20100930002494 VA DME Supplier - Physician - Optometrist 0446249858 1 other NPI on this enrollment
Practice locations: Roanoke, VA
O20200601001140 WV Part B Supplier - Clinic/Group Practice 0446249858 Receives reassigned benefits from 2 practitioners
Practice locations: Princeton, WV; Ronceverte, WV

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

609 Northside Dr
Martinsville, VA 24112

102 Highland Ave SE
Roanoke, VA 24013
Phone (540) 224-4545

1819 Electric Rd
Ste 1A
Roanoke, VA 24018

2154 McVitty Rd SW
Roanoke, VA 24018

2154 McVitty Rd SW
Ste 100
Roanoke, VA 24018

70 Summerfield Ct
Roanoke, VA 24019
Phone (540) 855-5139

707 S Jefferson St
Roanoke, VA 24016
Phone (540) 344-4000

426 W Main St
Salem, VA 24153
Phone (540) 344-4000

470 Lithia Rd
#1
Wytheville, VA 24382

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432684800000",
    "number": "1457323545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1789",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240081789",
            "telephone_number": "540-855-5139",
            "fax_number": "540-342-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S JEFFERSON ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240165100",
            "telephone_number": "540-855-5139",
            "fax_number": "540-342-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTAR EYE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-03",
        "last_updated": "2015-05-27",
        "status": "A",
        "authorized_official_last_name": "LEVY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "540-855-5123",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.