Alayna Larsen, OD
Individual provider Active NPI Vision Therapy Optometrist · Roswell, GA
NPI 1780163691 · NPPES record last updated Dec 12, 2021
Key facts
- NPI
- 1780163691
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Vision Therapy Optometrist 152WV0400X
- License
- OPT003208 (GA)
- Practice address
- 11735 Pointe PL
Roswell, GA 30076-4636 - Phone
- (954) 262-4235
- Fax
- (954) 262-3904
- NPI assigned
- Aug 10, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Eagle View Eye Care LLC
Practice addresses (Care Compare)
1211 Bald Ridge Marina Rd
Cumming, GA 30041-8484
Phone (706) 419-9240
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200130001454 | GA | Practitioner - Optometry | 9931445038 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT003208 | GA | MD | Vision Therapy Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eagle View Eye Care, LLC | Optometrist | Current |
Accepting new patients |
| Vision Care & Therapy Center, Inc | Optometrist | Current |
Accepting new patients |
| Nova Southeastern University, Inc | Past | Accepting new patients |
Locations
1211 Bald Ridge Marina Rd
Cumming, GA 30041
Phone (470) 239-6620
4008 Mundy Mill Rd
Oakwood, GA 30566
Phone (770) 534-5305
11735 Pointe Pl
Roswell, GA 30076
Phone (678) 256-3990
12020 Etris Rd
Ste B100
Roswell, GA 30075
Phone (678) 256-3990
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vision Therapy Optometrist |
152WV0400X | OPT003208 | GA | Yes |
Addresses
Primary practice location
11735 Pointe PL
Roswell, GA 30076-4636
Mailing address
155 Hopewell Grove Dr
Milton, GA 30004-6989
Phone (561) 356-5619
Other providers in Roswell, GA
- Cynthia Anne Lang
- Selena Langbehn
- Valerie L Lanier
- Irit Lantzman
- Samantha Laratta
- Kristy Larsen
- Michelle Yvonne Larue
- Meredith A Lassiter
- Lauer Enterprises LLC
- Edward C Lauria
All providers in Roswell, GA · Vision Therapy Optometrist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.