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TARA N VAN DE WYNGAERDE OD PC
NPI 1215128806
Optometrist in Mendota, IL

Active since August 07, 2007
700 14TH AVE, MENDOTA, IL 61342(815) 539-6291(815) 539-3035 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tara N Van De Wyngaerde Od Pc NPPES

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

TARA N VAN DE WYNGAERDE OD PC (NPI 1215128806) is a healthcare organization registered as an optometrist in Mendota, Illinois and active in the NPI registry since August 2007. The organization lists Tara Nicole Vandewyngaerde, Owner/optometrist, as its authorized official.

NPPES Registry Identity

NPI1215128806
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameTARA N VAN DE WYNGAERDE OD PC
Location Address700 14TH AVEMendota, IL 61342-1412
Mailing Address700 14th AveMendota, IL 61342-1412 · (815) 539-6291 · Fax (815) 539-3035
Phone(815) 539-6291
Fax(815) 539-3035
Organization SubpartNo
Authorized OfficialTara Nicole VandewyngaerdeOwner/optometrist · (815) 539-6291
Enumeration DateAugust 7, 2007
Last NPPES UpdateNovember 21, 2025
NPPES CertifiedNovember 21, 2025
✔ NPI 1215128806 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in IL · 046009989
Definition
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.
700 14TH AVE, Mendota, IL 61342
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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

Medical Equipment Supplier Medicare DMEPOS 2

Medicare supplier enrollment and the product categories Tara N Vandewyngaerde Od PC carries, from the Medicare DMEPOS supplier directory.

Tara N Vandewyngaerde Od PC

DMEPOS supplier · Mendota, IL
✔

Accepts Medicare assignment

Tara N Vandewyngaerde Od PC agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20564771
Medicare Participant SinceJuly 30, 2007
Supplier Location700 14th AveMendota, IL 61342
Phone(815) 539-6291
Supplier Specialties
Optometrist Optician

Medicare Product Categories

Prosthetic Lenses: Conventional Eyeglasses
Conventional Eyeglasses
Prosthetic Lenses: Conventional Contact Lenses
Conventional Contact Lenses
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 2

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

DR. TARA NICOLE VANDEWYNGAERDE O.D
Optometrist
700 14TH AVE
MENDOTA, IL 61342
Lasalle County (815) 539-6291
DR. PAUL DANIEL DOYLE OD
Ophthalmology
700 14TH AVE
MENDOTA, IL 61342
Lasalle County (815) 539-6291

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 Tara N Van De Wyngaerde Od PC's NPI number?

The NPI number for Tara N Van De Wyngaerde Od PC is 1215128806. It was assigned to this organization in the NPPES registry on August 7, 2007.

Where is Tara N Van De Wyngaerde Od PC located?

Tara N Van De Wyngaerde Od PC is located at 700 14th Ave, Mendota, IL 61342. The listed phone number is (815) 539-6291.

What is Tara N Van De Wyngaerde Od PC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Does Tara N Van De Wyngaerde Od PC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Tara N Vandewyngaerde Od PC accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

When was this NPI record last updated?

The NPPES record for Tara N Van De Wyngaerde Od PC was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.