Autumn M Mantel, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618003387 Issued in VA

Practice address

14465 Potomac Mills Rd
Woodbridge, VA 22192-6807

Phone

(703) 494-6184

Fax

(703) 499-9744

NPI assigned

Aug 2, 2006

Last updated

Apr 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA, NY, VA, MI, WI, OH, IN, PA, MD, DC10 enrollments

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 10

Specialty

Optometry

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Maryland LLCGroup PAC ID 6002037629, 121 clinicians

Myeyedr Optometry of Pennsylvania LLCGroup PAC ID 3971884883, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations (25 of 57)

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.

• Myeyedr Optometry of Maryland, LLC

  dba MyEyeDr

  • Optometrist
  • Waldorf, MD
  • NPI 1609204437
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Pennsylvania, LLC

  dba MyEyeDr.

  • Optometrist
  • Carlisle, PA
  • NPI 1003264607
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Virginia PLLC

  dba MyEyeDr

  • Optometrist
  • Ashburn, VA
  • NPI 1174933691
  Medicare reassignment NPD
• Empire Vision Center Inc

  dba Davis Vision

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  Medicare reassignment NPD
• Myeyedr Optometry of Indiana, LLC

  dba MyEyeDr.

  • Optometrist
  • Lebanon, IN
  • NPI 1083100424
  Medicare reassignment NPD
• Myeyedr Optometry of Maryland, LLC

  dba MyEyeDr.

  • Optometrist
  • Clinton, MD
  • NPI 1497124796

  DC

  Medicare reassignment NPD
• Myeyedr Optometry of Michigan, LLC

  dba MyEyeDr.

  • Optometrist
  • Shelby Township, MI
  • NPI 1639723596
  Medicare reassignment NPD
• Myeyedr Optometry of Ohio, LLC

  dba MyEyeDr.

  • Optometrist
  • Dayton, OH
  • NPI 1902365448
  Medicare reassignment NPD
• Myeyedr Optometry of Wisconsin, LLC

  dba MyEyeDr.

  • Optometrist
  • Kenosha, WI
  • NPI 1164992996
  Medicare reassignment NPD
• Proliance Surgeons Inc P S

  dba Proliance Surgeons Orthopedic Specialists of Seattle

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment NPD
• Myeyedr Optometry of Virginia, PLLC

  dba MyEyeDr.

  • Optometrist
  • Falls Church, VA
  • NPI 1710343744

  DC

  Medicare reassignment
• Myeyedr Optometry of Virginia, PLLC

  dba MyEyeDr.

  • Optometrist
  • Fairfax, VA
  • NPI 1083502793
  NPD

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1740297829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14465 POTOMAC MILLS RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221926807",
            "telephone_number": "703-494-6184",
            "fax_number": "703-499-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTEL",
        "first_name": "AUTUMN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003988",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618003387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1048492",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LABOR & INDUSTRIES",
            "identifier": "368024",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheila A. Mannion, PTA
• Manolisa T Cornel- Manaloto MD PLC
• David Mansaray
• Tracey Denise Mansfield
• Marcel Mansour, RPH
• Comfort Asaa Mantey, RPH
• Leidy Viviana Mantilla Galeano, DMD
• Jennifer K Manuk
• Emily Manza, LCSW
• Mapledale Family Dentistry, P.C.

• Optometrist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.