Tracy A Dzibela, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001918 Issued in VA

Practice address

402 Airport Rd
Tappahannock, VA 22560-5431

Phone

(804) 443-5388

NPI assigned

Oct 12, 2006

Last updated

Nov 7, 2020By 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

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adam H Madison OdpcGroup PAC ID 0446225841, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Adam H Madison Odpc

  dba Eye Care Doctors Of Optometry

  • Optometrist
  • Fredericksburg, VA
  • NPI 1518993641
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604707200000",
    "number": "1912096314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1290",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245511290",
            "telephone_number": "434-385-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 AIRPORT RD",
            "city": "TAPPAHANNOCK",
            "state": "VA",
            "postal_code": "225605431",
            "telephone_number": "804-443-5388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224051924",
            "country_code": "US",
            "telephone_number": "540-371-2020",
            "fax_number": "540-373-0141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DZIBELA",
        "first_name": "TRACY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-11-07",
        "certification_date": "2020-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00598100",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Complete Care Medical Group
• Comprehensive Eyecare of Virginia
• Cornerstone Behavioral Health Solutions, LLC
• Bonnie Deschner, MD
• James Flinn Donecker, M.D.
• Phyllis Grimmer Eberline, PT,DPT
• Thomas Amos Elliott
• Kwame Binfo Ennin, PHARMD
• Rosemary Theresa Enright, M.D.
• Essex County EMS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2020; 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.