Individual provider Active NPI

Lauren P Rivellino, OD

  • Optometrist
  • Staunton, VA
National Provider Identifier
1891945697
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618001753 Issued in VA
Practice address
1500 Commerce Rd
Staunton, VA 24401-9032
Phone
(540) 213-7720
Fax
(540) 213-9441
NPI assigned
Sep 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001753 VA Primary

Addresses

Primary practice location

1500 Commerce Rd
Staunton, VA 24401-9032

Mailing address

17 N Medical Park Dr
Fishersville, VA 22939-2344
Phone (540) 213-7720

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lauren.parker.p1@direct.eyeoneva.nextgenshare.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20120919000597 VA Practitioner - Optometry 7810145653 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stephen T Basic III OD and Associates PLLCGroup PAC ID 4082868989, 5 clinicians

Practice addresses (Care Compare)

1114 Emmet St N
Suite D
Charlottesville, VA 22903-4841
Phone (434) 971-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Vision Optometry P.C. Optometrist CurrentSince Jul 1, 2023 Accepting new patients
Spring Creek Eyecare LLC Optometrist CurrentSince Oct 1, 2023 Accepting new patients
Stephen T Basic III OD and Associates PLLC Optometrist CurrentSince Oct 9, 2023 Accepting new patients

Locations

1200 Five Springs Rd
Ste G1
Charlottesvle, VA 22902
Phone (434) 207-4040

1114 Emmet St N
Ste D
Charlottesvle, VA 22903
Phone (434) 971-2020

4 Ridgewood Pkwy
Newport News, VA 23602
Phone (757) 703-4200

200 W Constance Rd
Suffolk, VA 23434
Phone (347) 829-6863

4142 Bonney Rd
Virginia Beach, VA 23452
Phone (757) 340-0620

Interoperability endpoints

  • Direct secure messaging: lauren.rivellino.p1@direct.eyeone.nextgenshare.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1891945697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 N MEDICAL PARK DR",
            "city": "FISHERSVILLE",
            "state": "VA",
            "postal_code": "229392344",
            "telephone_number": "540-213-7720",
            "fax_number": "540-213-7729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 COMMERCE RD",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244019032",
            "telephone_number": "540-213-7720",
            "fax_number": "540-213-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVELLINO",
        "first_name": "LAUREN",
        "middle_name": "P",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lauren.parker.p1@direct.eyeoneva.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1500 Commerce Rd",
            "city": "Staunton",
            "state": "VA",
            "country_code": "US",
            "postal_code": "244019032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Staunton, VA

Sources for this page

Verify at the official NPI Registry.