Individual provider Active NPI

Tammy Lynn Carlson, OD

  • Optometrist
  • Vandling, PA
National Provider Identifier
1962462291
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000885 Issued in PA
Practice address
852 Main St
Vandling, PA 18421-1549
Phone
(570) 785-5367
NPI assigned
Mar 23, 2006
Last updated
Jun 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV0061061 NY
Optometrist 152W00000X OEG000885 PA Primary

Addresses

Primary practice location

852 Main St
Vandling, PA 18421-1549

Mailing address

852 Main St
Vandling, PA 18421-1549
Phone (570) 785-5367

Other identifiers 2

IdentifierTypeStateIssuer
P00775085OtherPAMEDICARE RAILROAD PTAN
0019400280001MedicaidPA

Other names 1

  • Tammy Lynn Hurley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100616000660 PA Practitioner - Optometry 1153416490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

852 Main St
Vandling, PA 18421-1549
Phone (570) 785-5367

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV0061061NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
T L C Family Eye Care Inc Optometrist CurrentSince Dec 20, 2002 Accepting new patients
Empire Vision Center, Inc Past Accepting new patients
Empire Vision Center Inc Optometrist PastSince Aug 9, 2010 Accepting new patients

Locations

852 Main St
Vandling, PA 18421
Phone (570) 785-5367

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1962462291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "852 MAIN ST",
            "city": "VANDLING",
            "state": "PA",
            "postal_code": "184211549",
            "telephone_number": "570-785-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 MAIN ST",
            "city": "VANDLING",
            "state": "PA",
            "postal_code": "184211549",
            "telephone_number": "570-785-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "TAMMY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV0061061",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN",
            "identifier": "P00775085",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019400280001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "HURLEY",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vandling, PA

Sources for this page

Verify at the official NPI Registry.