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ADVANCED EYE CARE MEDICAL CENTER
NPI 1124460621
Ophthalmology in Glenn Dale, MD

Active since July 24, 2013CLIA 21D2074338 · Waiver
12200 ANNAPOLIS RD, SUITE 116, GLENN DALE, MD 20769(301) 805-4664 Get Directions Write a Review

NPPES record last updated: March 23, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Advanced Eye Care Medical Center NPPES

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

ADVANCED EYE CARE MEDICAL CENTER (NPI 1124460621), doing business as Envision Eye & Laser Center, is a healthcare organization registered as an ophthalmology in Glenn Dale, Maryland and active in the NPI registry since July 2013. The organization holds a CLIA Waiver certificate valid through July 15, 2027 and lists Renee C Bovelle, Owner, as its authorized official.

NPPES Registry Identity

NPI1124460621
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameADVANCED EYE CARE MEDICAL CENTER
Location Address12200 ANNAPOLIS RD, SUITE 116Glenn Dale, MD 20769-9182
Mailing Address12200 Annapolis Rd, Suite 116Glenn Dale, MD 20769-9182 · (301) 805-4664
Phone(301) 805-4664
Organization SubpartNo
Authorized OfficialRenee C BovelleOwner · (301) 805-4664
Enumeration DateJuly 24, 2013
Last NPPES UpdateMarch 23, 2016
✔ NPI 1124460621 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
12200 ANNAPOLIS RD, Glenn Dale, MD 20769
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Other Names 1

Former Legal Business NameEnvision Eye & Laser Center

Other Identifiers 1

Medicare PIN1790990505DC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2074338

Envision Eye & Laser Center · Glenn Dale, MD
Active · expires Jul 15, 2027
CLIA Number21D2074338
Laboratory TypePhysician Office
Certificate Effective DateJuly 16, 2025
Certificate Expiration DateJuly 15, 2027
Laboratory DirectorRenee C. Bovelle
Laboratory Phone(301) 805-4664
Laboratory LocationEnvision Eye & Laser Center12200 Annapolis Road Suite 116, Glenn Dale, MD 20769
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARYLAND SPECIALTY GROUP LLC
Obstetrics & Gynecology
12200 ANNAPOLIS RD, SUITE# 123
GLENN DALE, MD 20769
Prince George's County (301) 552-9495
MARTHA JOHNSON
Massage Therapist
12200 ANNAPOLIS RD, SUITE 221
GLENN DALE, MD 20769
Prince George's County (301) 352-2991
WHOLISTIC RESTORATIONS LLC
Clinic/Center (Adult Mental Health)
12200 ANNAPOLIS RD, SUITE 320
GLENN DALE, MD 20769
Prince George's County (301) 399-9119
MARYLAND SPECIALTY GROUP LLC
Surgery (Vascular Surgery)
12200 ANNAPOLIS RD, STE 123
GLENN DALE, MD 20769
Prince George's County (301) 552-9495
LARRY W. BRYANT DDS, PC
Dentist (Oral and Maxillofacial Surgery)
12200 ANNAPOLIS RD, SUITE 236-240
GLENN DALE, MD 20769
Prince George's County (301) 249-0553
DR. VALERIE DAWN CALLENDER M.D.
Dermatology
12200 ANNAPOLIS RD, SUITE 315
GLENN DALE, MD 20769
Prince George's County (301) 249-0970
NICOLE C LAWSON OT
Occupational Therapist
12200 ANNAPOLIS RD, SUITE 225
GLENN DALE, MD 20769
Prince George's County (301) 860-0003
IKECHI F OKWARA MD
Internal Medicine
12200 ANNAPOLIS RD, STE 316
GLENN DALE, MD 20769
Prince George's County (301) 313-0600

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 Advanced Eye Care Medical Center's NPI number?

The NPI number for Advanced Eye Care Medical Center is 1124460621. It was assigned to this organization in the NPPES registry on July 24, 2013. The provider was formerly known as Envision Eye & Laser Center.

Where is Advanced Eye Care Medical Center located?

Advanced Eye Care Medical Center is located at 12200 Annapolis Rd Suite 116, Glenn Dale, MD 20769. The listed phone number is (301) 805-4664.

What is Advanced Eye Care Medical Center's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Does Advanced Eye Care Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2074338) is associated with this NPI, valid through July 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Advanced Eye Care Medical Center was last updated on March 23, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.