Organization Active NPI

Optical Expressions Berlin, LLC

  • Optometrist
  • Barre, VT
National Provider Identifier
1740442417
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
L0023504 Issued in VT
Legal business name
OPTICAL EXPRESSIONS BERLIN, LLC
Practice address
14 N Main St Ste 4002
Barre, VT 05641-4505
Phone
(802) 223-2090
Fax
(802) 223-5336
NPI assigned
Jun 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Sally Anne Boyle
Title
Office Manager
Phone
(802) 223-2090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X L0023504 VT Primary

Addresses

Primary practice location

14 N Main St Ste 4002
Barre, VT 05641-4505

Mailing address

14 N Main St Ste 4002
Barre, VT 05641-4505
Phone (802) 223-2090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080925000525 VT Part B Supplier - Clinic/Group Practice 8224105747 Receives reassigned benefits from 3 practitioners
Practice locations: Barre, VT

National Provider Directory

National Provider Directory

Locations

14 N Main St
Ste 4002
Barre, VT 05641
Phone (802) 223-2090

282 Berlin Mall Rd
Berlin, VT 05602
Phone (802) 223-2090

282 Berlin Mall Rd
Ste 4
Berlin, VT 05602
Phone (802) 223-2090

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1740442417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 N MAIN ST STE 4002",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056414505",
            "telephone_number": "802-223-2090",
            "fax_number": "802-223-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 N MAIN ST STE 4002",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056414505",
            "telephone_number": "802-223-2090",
            "fax_number": "802-223-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL EXPRESSIONS BERLIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "802-223-2090"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VT",
            "license": "L0023504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barre, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.