Elizabeth Wassenaar, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODTG00654 Issued in RI

Practice address

150 E Manning St
Providence, RI 02906

Phone

(401) 272-2020

Fax

(401) 421-5979

NPI assigned

Jul 10, 2017

Last updated

Mar 12, 2026By 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 RI

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

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prytula Eye Associates IncGroup PAC ID 5294090510, 3 clinicians

Eyediology Vision LLCGroup PAC ID 4688059413, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Eyediology Vision, LLC

  • Optometrist
  • Providence, RI
  • NPI 1063141166
  Medicare reassignment Care Compare group NPD
• Prytula Eye Associates Inc

  dba Acuity Vision & Eyewear Center

  • Optometrist
  • Coventry, RI
  • NPI 1790293850
  Medicare reassignment Care Compare group NPD
• 4Sight Eyewear Inc.

  • Optometrist
  • Woonsocket, RI
  • NPI 1881329316
  NPD
• Mark G. Blasbalg OD Inc

  • Optometrist
  • Coventry, RI
  • NPI 1902963457
  NPD (past)

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1972025187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 POWER ST APT 1",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063953",
            "telephone_number": "312-301-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E MANNING ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02906",
            "telephone_number": "401-272-2020",
            "fax_number": "401-421-5979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Waterman St Ste 309",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029065215",
            "country_code": "US",
            "telephone_number": "401-227-2188",
            "fax_number": "401-227-2183",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "385 Mendon Rd",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028952477",
            "country_code": "US",
            "telephone_number": "401-762-4473",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1601 Brenner Ave",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281442515",
            "country_code": "US",
            "telephone_number": "704-638-3825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASSENAAR",
        "first_name": "ELIZABETH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTG00654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Warren, MD/PHD
• Sarita S. Warrier, M.D.
• Ruth J Wartenberg, LICSW
• Washington Park Citizens Association, Inc. (Washington Park Children's Shelter)
• Elisa Marie Wasilewski, PA-C
• Meredith Caroline Wasserman, MD
• Waterman Dental LLC
• Alexandra Waters, MSN, APRN, FNP-BC
• Henri Paul Wathieu, MD
• Natacha Wathieu, MD

• Optometrist in Providence, RI
• Providers in Providence, RI by specialty
• Optometrist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.