Individual provider Active NPI

Amy Christine Sickinger, OD

  • Optometrist
  • White River Junction, VT
National Provider Identifier
1477209278
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
030.0133948 Issued in VT
Practice address
215 North Main Street Desk 100, Eye Clinic (112)
White River Junction, VT 05009-0001
Phone
(802) 295-9363
NPI assigned
Mar 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 030.0133948 VT Primary

Addresses

Primary practice location

215 North Main Street Desk 100, Eye Clinic (112)
White River Junction, VT 05009-0001

Mailing address

215 North Main Street Desk 100, Eye Clinic (112)
White River Junction, VT 05009-0001
Phone (802) 295-9363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20220606000982 MA Practitioner - Optometry 7214315100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Boston Community Health CenterGroup PAC ID 2062487291, 57 clinicians

Practice addresses (Care Compare)

409 W Broadway
South Boston, MA 02127-2245
Phone (617) 269-7500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030.0133948VTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
South Boston Community Health Center CurrentSince May 24, 2022 Accepting new patients

Locations

409 W Broadway
South Boston, MA 02127
Phone (617) 269-7500

Interoperability endpoints

  • Direct secure messaging: asickinger287534@direct.ochin.org

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 and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1477209278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 NORTH MAIN STREET DESK 100, EYE CLINIC (112)",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050090001",
            "telephone_number": "802-295-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 NORTH MAIN STREET DESK 100, EYE CLINIC (112)",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050090001",
            "telephone_number": "802-295-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICKINGER",
        "first_name": "AMY",
        "middle_name": "CHRISTINE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030.0133948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White River Junction, VT

Sources for this page

Verify at the official NPI Registry.