Active NPI
Richard L. Leven, O.D.
- Optometrist
- St Johnsbury, VT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 030-0000158
- Practice address
- 468 Hospital Dr
St Johnsbury, VT 05819-9225 - Phone
- (802) 748-3536
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 030-0000158 | VT | Primary |
Addresses
Primary practice location
468 Hospital Dr
St Johnsbury, VT 05819-9225
Mailing address
468 Hospital Dr
St Johnsbury, VT 05819-9225
Phone (802) 483-5367
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0007949 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100406000624 | VT | Practitioner - Optometry | 6103817481 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shippee Family Eye Care PC | Optometrist | Current | Accepting new patients |
| Shippee Family Eye Care PC | Optometrist | Current | Accepting new patients |
Locations
2000 Memorial Dr
Ste 6
St Johnsbury, VT 05819
Phone (802) 318-4768
468 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 223-7723
Interoperability endpoints
- rleven@shippeestj.eyefinitydirect.com
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Three Rivers Comm. Counseling SVS. | Federally qualified health center | Corporate Director | May 27, 2011 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Federally Qualified Health Center (FQHC)
- St Johnsbury, VT
- NPI 1649236225
Corporate Director
Organizations & group practices 2
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.
-
- Optometrist
- St Johnsbury, VT
- NPI 1023407467
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588809600000",
"number": "1962517292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "468 HOSPITAL DR",
"city": "ST JOHNSBURY",
"state": "VT",
"postal_code": "058199225",
"telephone_number": "802-483-5367",
"fax_number": "802-748-4838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "468 HOSPITAL DR",
"city": "ST JOHNSBURY",
"state": "VT",
"postal_code": "058199225",
"telephone_number": "802-748-3536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEVEN",
"first_name": "RICHARD",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2020-05-07",
"certification_date": "2020-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "VT",
"license": "030-0000158",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0007949",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Johnsbury, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.