Vladislav Petcov, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG002362 Issued in PA

Practice address

40 Noble Blvd Ste 120
Carlisle, PA 17013-4122

Phone

(717) 218-6656

Fax

(717) 243-0738

NPI assigned

Jul 21, 2010

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

Medicare fee-for-service enrollment

Enrolled in PA

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

Pennsylvania College of Optometry, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Pennsylvania LLCGroup PAC ID 3971884883, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Myeyedr Optometry of Pennsylvania, LLC

  dba MyEyeDr.

  • Optometrist
  • Carlisle, PA
  • NPI 1003264607
  Medicare reassignment Care Compare group NPD
• Dombrowski Eye Associates

  • Optometrist
  • Lancaster, PA
  • NPI 1790719714
  Medicare reassignment NPD
• Myeyedr Optometry of Pennsylvania, LLC

  • Optometrist
  • Cranberry Township, PA
  • NPI 1093688491
  NPD
• Myeyedr. Optometry of Pennsylvania, LLC

  dba MyEyeDr.

  • Optometrist
  • York, PA
  • NPI 1477098622
  NPD

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1659684595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 NOBLE BLVD STE 120",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170134122",
            "telephone_number": "717-218-6656",
            "fax_number": "717-243-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETCOV",
        "first_name": "VLADISLAV",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-21",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pennsylvania CVS Pharmacy LLC (CVS Pharmacy #17185)
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #01646)
• Teadra Pennycooke, CRNP
• Anna Pepler
• Allyn G. Perkins, D.M.D.
• Bethany Peters
• Lori Peters, LPC
• Deanna Petula, PT
• Christa Peyton, DDS
• Courtney Pflug

• Optometrist in Carlisle, PA
• Providers in Carlisle, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.