Tara N. Van De Wyngaerde, O.d., P.c. is a medicare enrolled "Optometrist" provider in Mendota, Illinois. Their current practice location is
700 14th Ave, Mendota, Illinois. You can reach out to their office (for appointments etc.) via phone at
(815) 539-6291.
Tara N. Van De Wyngaerde, O.d., P.c. is licensed to practice in Illinois (license number 046009989) and it also participates in the medicare program. Tara N. Van De Wyngaerde, O.d., P.c.
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1215128806.
Healthcare Provider's Profile
| Full Name | Tara N. Van De Wyngaerde, O.d., P.c. |
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| Type | Facility |
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| Speciality | Optometrist |
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| Location | 700 14th Ave, Mendota, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1215128806
- Provider Enumeration Date: 08/07/2007
- Last Update Date: 02/25/2011
Medicare PECOS Information:
- PECOS PAC ID: 7012001613
- Enrollment ID: O20070921000286
Medical Identifiers
Medical identifiers for Tara N. Van De Wyngaerde, O.d., P.c. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215128806 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 046009989 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Tara N. Van De Wyngaerde, O.d., P.c. acts as a billing entity for following providers:
| Provider Name | Tara N Vandewyngaerde |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1528264603
PECOS PAC ID: 7113011719
Enrollment ID: I20070913000143 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tara N. Van De Wyngaerde, O.d., P.c. is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tara N. Van De Wyngaerde, O.d., P.c.
700 14th Ave,
Mendota, IL 61342-1412
Ph: (815) 539-6291 | Tara N. Van De Wyngaerde, O.d., P.c.
700 14th Ave,
Mendota, IL 61342-1412
Ph: (815) 539-6291 |
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