TARA N VAN DE WYNGAERDE OD PC
NPI 1215128806
Optometrist in Mendota, IL
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
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tara N Van De Wyngaerde Od Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Tara N Van De Wyngaerde Od PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, ILAccepts 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.
Medicare Product Categories
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.
Is Tara N Van De Wyngaerde Od PC enrolled in Medicare?
Yes. Tara N Van De Wyngaerde Od PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Tara N Van De Wyngaerde Od PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Tara N Van De Wyngaerde Od PC. 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.
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 11 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.
# Tara N Van De Wyngaerde Od Pc · NPI 1215128806
Optometrist organization in Mendota, Illinois. Organization record, active in the CMS NPPES registry since August 7, 2007.
## Identity
- **NPI:** 1215128806 (Entity type: Organization)
- **Enumerated:** August 7, 2007
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Tara Vandewyngaerde, OWNER/OPTOMETRIST
## Practice location
- **Address:** 700 14TH AVE, Mendota, IL 61342-1412
- **Phone:** (815) 539-6291 · **Fax:** (815) 539-3035
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Optometry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 21, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1215128806) · Data from the CMS NPPES public registry.