Individual provider Active NPI

Richard L. Leven, O.D.

  • Optometrist
  • St Johnsbury, VT
National Provider Identifier
1962517292
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
030-0000158 Issued in VT
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

Updated by the provider on May 7, 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 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

IdentifierTypeStateIssuer
0007949MedicaidVT

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100406000624 VT Practitioner - Optometry 6103817481

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shippee Family Eye Care PC Optometrist CurrentSince Feb 3, 2015 Accepting new patients
Shippee Family Eye Care PC Optometrist CurrentSince Feb 3, 2015 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

  • Direct secure messaging: 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.

FacilityTypeRoleSince
Three Rivers Comm. Counseling SVS.Saint Johnsbury, VT, CCN 471810 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.

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.

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

Verify at the official NPI Registry.