POOLESVILLE VISION SERVICE
NPI 1114206943
Optometrist in Poolesville, MD
About Poolesville Vision Service NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
POOLESVILLE VISION SERVICE (NPI 1114206943) is a healthcare organization registered as an optometrist in Poolesville, Maryland and active in the NPI registry since August 2011. The organization lists Robin Mevissen, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 7
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Poolesville Vision Service is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Poolesville Vision Service, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 Poolesville Vision And Contact Lens Service's NPI number?
The NPI number for Poolesville Vision And Contact Lens Service is 1114206943. It was assigned to this organization in the NPPES registry on August 10, 2011. The provider is doing business as Poolesville Vision Service.
Where is Poolesville Vision And Contact Lens Service located?
Poolesville Vision And Contact Lens Service is located at 20005 B Fisher Ave, Poolesville, MD 20837. The listed phone number is (301) 916-3214.
What is Poolesville Vision And Contact Lens Service's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Poolesville Vision And Contact Lens Service enrolled in Medicare?
Yes. Poolesville Vision And Contact Lens Service is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Poolesville Vision And Contact Lens Service?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Optometry, reassign their Medicare billing to Poolesville Vision And Contact Lens Service. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Poolesville Vision And Contact Lens Service accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 2 other insurers list Poolesville Vision And Contact Lens Service 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 Poolesville Vision And Contact Lens Service was last updated on August 9, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Poolesville Vision Service · NPI 1114206943
Optometrist organization in Poolesville, Maryland. Organization record, active in the CMS NPPES registry since August 10, 2011.
## Identity
- **NPI:** 1114206943 (Entity type: Organization)
- **Enumerated:** August 10, 2011
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Legal business name:** Poolesville Vision And Contact Lens Service
- **Organization subpart:** No
- **Authorized official:** Robin Mevissen, OWNER
## Practice location
- **Address:** 20005 B FISHER AVE, Poolesville, MD 20837-2408
- **Phone:** (301) 916-3214 · **Fax:** (301) 916-3101
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 9, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1114206943) · Data from the CMS NPPES public registry.