| Advanced Eyecare Pc | |
|
322 Dewey St, Bennington, VT 05201-2225 | |
| (802) 447-8700 | |
| (802) 447-1500 |
| Full Name | Advanced Eyecare Pc |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 322 Dewey St, Bennington, Vermont |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790739340 | NPI | - | NPPES |
| 110072172A | Medicaid | MA | |
| ADVA318-19924 | Other | VT | VTBS |
| ADVA318-19924 | Other | MA | VTBS |
| M16004 | Other | MA | MABS |
| M16004 | Other | VT | MABS |
| VN0966 | Medicaid | VT | |
| 1059 | Other | VT | CDPHP |
| 200052887 | Other | MA | MVP |
| 614906 | Other | MA | TUFTS |
| 01794247 | Medicaid | NY | |
| 1268 | Other | VT | HNE |
| 1059 | Other | MA | CDPHP |
| 1268 | Other | MA | HNE |
| 200052887 | Other | VT | MVP |
| VT0949 | Medicaid | VT | |
| 614906 | Other | VT | TUFTS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (Vermont) | Secondary |
| 207W00000X | Ophthalmology | (Massachusetts) | Secondary |
| 207W00000X | Ophthalmology | (Vermont) | Primary |
| Provider Name | Erik W Niemi |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1194772491 PECOS PAC ID: 5799874376 Enrollment ID: I20100903000694 |
| Provider Name | Pawan Bhatnagar |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1821057233 PECOS PAC ID: 0345316501 Enrollment ID: I20150216000822 |
| Provider Name | Naomi S Falk |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1649271859 PECOS PAC ID: 9931258621 Enrollment ID: I20150217002155 |
| Provider Name | Jonathan Isaac Huz |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1124384714 PECOS PAC ID: 9436442803 Enrollment ID: I20161207001308 |
| Provider Name | George O Stasior |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1649281528 PECOS PAC ID: 5890961825 Enrollment ID: I20170210001790 |
| Provider Name | Thomas Allen Woltjer |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1376989202 PECOS PAC ID: 5890065098 Enrollment ID: I20170810001123 |
| Provider Name | Howard L Tanenbaum |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1215956792 PECOS PAC ID: 6507969151 Enrollment ID: I20170913001855 |
| Provider Name | Chad P Bouchard |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1831328053 PECOS PAC ID: 4587989538 Enrollment ID: I20181105003275 |
| Provider Name | Heidi H Welnak |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609484179 PECOS PAC ID: 5496172876 Enrollment ID: I20200831002175 |
| Provider Name | Estela Ogiste |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1780684902 PECOS PAC ID: 8820071426 Enrollment ID: I20201210001113 |
| Provider Name | Matthew M Habib |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1952899783 PECOS PAC ID: 0547595647 Enrollment ID: I20230224000919 |
| Provider Name | Gina Mahatma |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1043873128 PECOS PAC ID: 7012374713 Enrollment ID: I20240709003465 |
| Provider Name | Philip R Conkling |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1689202525 PECOS PAC ID: 9133663487 Enrollment ID: I20250610001034 |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Eyecare Pc 322 Dewey St, Bennington, VT 05201-2225 Ph: (802) 447-8700 | Advanced Eyecare Pc 322 Dewey St, Bennington, VT 05201-2225 Ph: (802) 447-8700 |