Organization Active NPI

Peninsula Eye Care, LLC

  • Optometrist
  • Yorktown, VA
National Provider Identifier
1710420856
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618002155 Issued in VA
Legal business name
PENINSULA EYE CARE, LLC
Practice address
1215 George Washington Mem Hwy Ste V
Yorktown, VA 23693-4316
Phone
(757) 978-2020
NPI assigned
Nov 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Authorized official

Name
Dr. David Buck, O.D.NPI 1245594407
Title
Sole Proprietor/Sole Manager
Phone
(757) 814-0827

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 0618002155 VA Primary

Addresses

Primary practice location

1215 George Washington Mem Hwy Ste V
Yorktown, VA 23693-4316

Mailing address

1215 George Washington Mem Hwy Ste V
Yorktown, VA 23693-4316
Phone (757) 978-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170719000613 VA Part B Supplier - Clinic/Group Practice 7911284377 Receives reassigned benefits from 6 practitioners
Practice locations: Yorktown, VA

National Provider Directory

National Provider Directory

Locations

1215 George Washington Mem Hwy
Ste D
Yorktown, VA 23693
Phone (757) 522-7117

1215 George Washington Mem Hwy
Yorktown, VA 23693

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1710420856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 GEORGE WASHINGTON MEM HWY STE V",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236934316",
            "telephone_number": "757-978-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 GEORGE WASHINGTON MEM HWY STE V",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236934316",
            "telephone_number": "757-978-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "BUCK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "SOLE PROPRIETOR/SOLE MANAGER",
        "authorized_official_telephone_number": "757-814-0827",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorktown, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.