Individual provider Active NPI

Donna Vann, O.D.

  • Optometrist
  • Wakefield, MA
National Provider Identifier
1902188477
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4891 Issued in MA
Practice address
22 Yale Ave
Wakefield, MA 01880-2309
Phone
(781) 245-1871
Fax
(781) 245-7963
NPI assigned
Sep 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4891 MA Primary

Addresses

Primary practice location

22 Yale Ave
Wakefield, MA 01880-2309

Mailing address

22 Yale Ave
Wakefield, MA 01880-2309
Phone (781) 245-1871

Other identifiers 1

IdentifierTypeStateIssuer
110090610AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20111108000706 MA Practitioner - Optometry 5698948693 Reassigns benefits to 2 organizations
I20170809004237 NH Practitioner - Optometry 5698948693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22 Yale Ave
Wakefield, MA 01880-2309
Phone (781) 245-1871

Merit-based Incentive Payment System (MIPS)

Final score
89.86 of 100Reported as group
Quality
86.06
Promoting interoperability
100
Improvement activities
40
Cost
76.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clearsight Vision Care LLC Optometrist CurrentSince Oct 1, 2024 Accepting new patients
Tallman Eye Associates, PC Optometrist CurrentSince Oct 3, 2011 Accepting new patients
Raffaele a Petrosino Optometrist PastSince Oct 1, 2024 Accepting new patients

Locations

360 Merrimack St
Ste 9
Lawrence, MA 01843
Phone (978) 552-4000

451 Andover St
North Andover, MA 01845
Phone (978) 687-1313

22 Yale Ave
Wakefield, MA 01880
Phone (781) 245-1871

29 Stiles Rd
Ste 101
Salem, NH 03079
Phone (603) 893-7400

Interoperability endpoints

  • Direct secure messaging: dvann@tea.ecldirect.net

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": "1315785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1902188477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 YALE AVE",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018802309",
            "telephone_number": "781-245-1871",
            "fax_number": "781-245-7963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 YALE AVE",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018802309",
            "telephone_number": "781-245-1871",
            "fax_number": "781-245-7963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANN",
        "first_name": "DONNA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "4891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110090610A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, MA

Sources for this page

Verify at the official NPI Registry.