ALISA THAVIKULWAT
NPI 1265827745
Ophthalmology in Glenn Dale, MD

Q: What is Alisa Thavikulwat's NPI number?

The NPI number for Alisa Thavikulwat is 1265827745. It was assigned to this individual provider in the NPPES registry on April 1, 2015.

Q: What is Alisa Thavikulwat's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Alisa Thavikulwat was last updated on September 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since April 01, 2015PECOS EnrolledAccepts Medicare Assignment

12150 ANNAPOLIS RD STE 111, GLENN DALE, MD 20769(301) 779-0844 Get Directions Write a Review

NPPES record last updated: September 24, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Alisa Thavikulwat NPPES

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

ALISA THAVIKULWAT (NPI 1265827745) is an individual ophthalmology provider in Glenn Dale, Maryland, licensed in Maryland (D0087217) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS and is a graduate of University Of Rochester School Of Medicine And Dentistry (2015).

NPPES Registry Identity

NPI1265827745

Entity TypeIndividualFemale

Primary Taxonomy207W00000X

Provider Legal NameALISA THAVIKULWAT

Location Address12150 ANNAPOLIS RD STE 111Glenn Dale, MD 20769-9183

Mailing Address1855 W Taylor St, Department Of OphthalmologyChicago, IL 60612-7242

Phone(301) 779-0844

Sole ProprietorYes

Medical School CMSUniversity Of Rochester School Of Medicine And DentistryGraduated 2015

Enumeration DateApril 1, 2015

Last NPPES UpdateSeptember 24, 2020

NPPES CertifiedSeptember 24, 2020

✔ NPI 1265827745 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in MD · D0087217

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.

12150 ANNAPOLIS RD STE 111, Glenn Dale, MD 20769

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Alisa Thavikulwat is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002102175

PECOS Enrollment IDI20200901001539

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 14

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

155 services100 patients

Extended exam of the back part of the eye with optic nerve drawing 92202

This procedure involves a detailed examination of the back part of your eye, focusing on the optic nerve, a crucial component for vision. A drawing or map of the optic nerve is created to help track any changes over time. This can help detect eye diseases early.

123 services117 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

113 services65 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

82 services71 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

79 services76 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

79 services78 patients

Exam of the internal drainage system of eye 92020

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

61 services59 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

52 services51 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

44 services44 patients

Established patient problem focused exam of visual system 92012

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

42 services39 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

28 services25 patients

Ultrasound scan of cornea to determine thickness 76514

An ultrasound scan of the cornea is a non-invasive procedure that uses sound waves to measure the thickness of your cornea. This helps in diagnosing certain eye conditions and planning treatments. No discomfort or pain is typically experienced.

25 services25 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

18 services15 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20769 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$147.85 typical visit price

range $65.18 – $194.86

Typical copayment $36.96 (range $16.29 – $48.71)

Most-billed visit code 99204

Established Patient

$80.66 typical visit price

range $21.40 – $158.88

Typical copayment $20.16 (range $5.35 – $39.72)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

VISIONMD, LLC

Ophthalmology

12150 ANNAPOLIS RD STE 111
GLENN DALE, MD 20769

Prince George's County (301) 779-0844

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 Alisa Thavikulwat's NPI number?

The NPI number for Alisa Thavikulwat is 1265827745. It was assigned to this individual provider in the NPPES registry on April 1, 2015.

Where is Alisa Thavikulwat located?

Alisa Thavikulwat practices at 12150 Annapolis Rd Ste 111, Glenn Dale, MD 20769. The listed phone number is (301) 779-0844.

What is Alisa Thavikulwat's specialty?

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

Is Alisa Thavikulwat enrolled in Medicare?

Yes. Alisa Thavikulwat is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Alisa Thavikulwat accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Providence Health Plan list Alisa Thavikulwat 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 Alisa Thavikulwat was last updated on September 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.