Individual provider Active NPI

Liane Carley Prytula, O.D.

  • Optometrist
  • Coventry, RI
National Provider Identifier
1669804753
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODTG00599 Issued in RI
Practice address
1193 Tiogue Ave
Coventry, RI 02816-6170
Phone
(401) 823-8200
NPI assigned
Jul 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODTG00599 RI Primary

Addresses

Primary practice location

1193 Tiogue Ave
Coventry, RI 02816-6170

Mailing address

1193 Tiogue Ave Unit 2
Coventry, RI 02816-6122
Phone (401) 823-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20131104000172 RI Practitioner - Optometry 5092940882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prytula Eye Associates IncGroup PAC ID 5294090510, 3 clinicians

Practice addresses (Care Compare)

1193 Tiogue Ave
Coventry, RI 02816-6170
Phone (401) 823-8200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODTG00599RIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Prytula Eye Associates Inc Optometrist CurrentSince Feb 13, 2015 Accepting new patients

Locations

1193 Tiogue Ave
Coventry, RI 02816
Phone (401) 823-8200

1193 Tiogue Ave
Unit 2
Coventry, RI 02816

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1669804753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1193 TIOGUE AVE UNIT 2",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028166122",
            "telephone_number": "401-823-8200",
            "fax_number": "401-826-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1193 TIOGUE AVE",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028166170",
            "telephone_number": "401-823-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYTULA",
        "first_name": "LIANE",
        "middle_name": "CARLEY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTG00599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coventry, RI

Sources for this page

Verify at the official NPI Registry.