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ENCHANTED MOUNTAIN EYECARE
NPI 1013294685
Eyewear Supplier in Olean, NY

Active since November 10, 2011
912 W STATE ST, OLEAN, NY 14760(716) 373-0766 Get Directions Write a Review

NPPES record last updated: November 10, 2011. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Enchanted Mountain Eyecare NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ENCHANTED MOUNTAIN EYECARE (NPI 1013294685) is a healthcare organization registered as an eyewear supplier in Olean, New York and active in the NPI registry since November 2011. The organization lists Tracy L Ludden, Optometrist, as its authorized official.

NPPES Registry Identity

NPI1013294685
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameENCHANTED MOUNTAIN OPTOMETRY,PLLC
Location Address912 W STATE STOlean, NY 14760-2242
Mailing Address912 W State StOlean, NY 14760-2242
Phone(716) 373-0766
Organization SubpartNo
Authorized OfficialTracy L LuddenOptometrist · (716) 373-0766
Enumeration DateNovember 10, 2011
✔ NPI 1013294685 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
License✔ Licensed in NY · T005716
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
912 W STATE ST, Olean, NY 14760
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Other Names 1

Doing Business AsEnchanted Mountain Eyecare

Other Identifiers 2

Medicare UPINLU11809BNY
Medicaid01608566NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Enchanted Mountain Eyecare is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNew YorkEnrollment IDO20111229000612Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Enchanted Mountain Eyecare, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tracy Ludden, OD
Optometry
NPI 1104916246
912 W STATE ST
Olean, NY 14760
(716) 373-0766
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Enchanted Mountain Optometry,pllc's NPI number?

The NPI number for Enchanted Mountain Optometry,pllc is 1013294685. It was assigned to this organization in the NPPES registry on November 10, 2011. The provider is doing business as Enchanted Mountain Eyecare.

Where is Enchanted Mountain Optometry,pllc located?

Enchanted Mountain Optometry,pllc is located at 912 W State St, Olean, NY 14760. The listed phone number is (716) 373-0766.

What is Enchanted Mountain Optometry,pllc's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Is Enchanted Mountain Optometry,pllc enrolled in Medicare?

Yes. Enchanted Mountain Optometry,pllc is registered in the Medicare PECOS enrollment system.

When is Enchanted Mountain Optometry,pllc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Enchanted Mountain Optometry,pllc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Enchanted Mountain Optometry,pllc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Enchanted Mountain Optometry,pllc accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Oscar Health list Enchanted Mountain Optometry,pllc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Enchanted Mountain Optometry,pllc was last updated on November 10, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.