Stacey Ann Tullis, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002411 Issued in VA

Practice address

8651 John J Kingman Rd
BLDG 2321
Ft Belvoir, VA 22060-6200

Phone

(703) 781-3695

NPI assigned

Jun 22, 2015

Sex

Female

Sole proprietor

Yes

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 CO

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

Southern California College of Optometry, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Total Vision Eye Care Group LLCGroup PAC ID 2163315854, 21 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.41 of 100Reported as group

Quality

88.72

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stacy.tullis.p6@direct.keec.nextgenshare.com

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

• Total Vision Eye Care Group LLC

  dba ICON Eyecare

  • Ophthalmology Physician
  • Denver, CO
  • NPI 1316109481
  Medicare reassignment Care Compare group NPD
• All About Eyes, LLC

  • Optometrist
  • Centennial, CO
  • NPI 1912224585
  Medicare reassignment NPD
• Lisa M Hamilton, PC

  dba Active Eyes, PC

  • Optometrist
  • Littleton, CO
  • NPI 1033320361
  Medicare reassignment NPD
• Total Vision Eye Care Group LLC

  • Ophthalmology Physician
  • Basalt, CO
  • NPI 1568248243
  NPD
• Total Vision Eye Care Group LLC

  dba ICON EyeCare

  • Ophthalmology Physician
  • Grand Junction, CO
  • NPI 1679176432
  NPD

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1689056020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 LYTTONSVILLE RD APT 907",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209101934",
            "telephone_number": "307-575-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8651 JOHN J KINGMAN RD",
            "address_2": "BLDG 2321",
            "city": "FT BELVOIR",
            "state": "VA",
            "postal_code": "220606200",
            "telephone_number": "703-781-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLIS",
        "first_name": "STACEY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Taylor Trest
• Dmitriy Treyster, MD, DABA, PA-C
• Sanh Dan Trieu, BS ,RPH
• Jerry Trotter, MD
• Frank Tucker, PA-C
• Tawanda Naomi Turner-Brown, LICENSED SOCIAL WORK
• Phuong Quynh Turner
• Karen Fay Tuttle-Trujillo, MSW, LICSW
• Michael Edward Uebele, CRNA
• Jennifer A Ulbricht, PH.D.

• Optometrist in Fort Belvoir, VA
• Providers in Fort Belvoir, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.