TARA N VAN DE WYNGAERDE OD PC
NPI 1215128806
Optometrist in Mendota, IL
NPI Status: Active since August 07, 2007
Contact Information
700 14TH AVE
MENDOTA, IL
ZIP 61342
Phone: (815) 539-6291
Fax: (815) 539-3035
- Organization
- Optometrist
- Medicare Supplier
- Accepts Medicare Approved Payment
About TARA N VAN DE WYNGAERDE OD PC
This page provides the complete NPI Profile along with additional information for Tara N Van De Wyngaerde Od Pc, a provider established in Mendota, Illinois operating as a Optometrist. The healthcare provider is registered in the NPI registry with number 1215128806 assigned on August 2007. The practitioner's primary taxonomy code is 152W00000X with license number 046009989 (IL). The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Tara Nicole Vandewyngaerde O.d. (Owner/optometrist)
- NPI
- 1215128806
- Provider Name
- TARA N VAN DE WYNGAERDE OD PC
- Entity Type
- Organization
- Location Address
- 700 14TH AVE MENDOTA, IL 61342
- Location Phone
- (815) 539-6291
- Location Fax
- (815) 539-3035
- Mailing Address
- 700 14TH AVE MENDOTA, IL 61342
- Mailing Phone
- (815) 539-6291
- Mailing Fax
- (815) 539-3035
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-07-2007
- Last Update Date
- 11-21-2025
- Code Navigator
Tara N Van De Wyngaerde Od Pc is a medicare supplier with PTAN 20564771 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Prosthetic Lenses: Conventional Eyeglasses or Prosthetic Lenses: Conventional Contact Lenses.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Optometrist
- Taxonomy Code
- 152W00000X
- Type
- Eye and Vision Services Providers
- License No.
- 046009989
- License State
- IL
- Taxonomy Description
- Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20564771
- Accepts Medicare Assignment
- YES
- Specialities List
- Optometrist, Optician.
- Competitive Bidding
- NO
Supplies List
- Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
- Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1215128806, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215128806, enumerated as an "organization" on August 07, 2007.
The provider is located at 700 14TH AVE MENDOTA, IL 61342 and the phone number is (815) 539-6291.
Optometrist with taxonomy code 152W00000X.
