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ADVANCED EYE CARE MEDICAL CENTER, PA
NPI 1790990505
Ophthalmology in Glenn Dale, MD

Active since May 14, 2007
12200 ANNAPOLIS RD, SUITE 116, GLENN DALE, MD 20769(301) 805-4664(301) 805-4663 Get Directions Write a Review

NPPES record last updated: May 23, 2013. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Advanced Eye Care Medical Center, Pa NPPES

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

ADVANCED EYE CARE MEDICAL CENTER, PA (NPI 1790990505) is a healthcare organization registered as an ophthalmology in Glenn Dale, Maryland and active in the NPI registry since May 2007. The organization lists Renee Bovelle, Owner, as its authorized official.

NPPES Registry Identity

NPI1790990505
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameADVANCED EYE CARE MEDICAL CENTER, PA
Location Address12200 ANNAPOLIS RD, SUITE 116Glenn Dale, MD 20769-9182
Mailing Address12200 Annapolis Rd, Suite 116Glenn Dale, MD 20769-9182 · (301) 805-4664 · Fax (301) 805-4663
Phone(301) 805-4664
Fax(301) 805-4663
Organization SubpartNo
Authorized OfficialRenee BovelleOwner · (301) 805-4664
Enumeration DateMay 14, 2007
Last NPPES UpdateMay 23, 2013
✔ NPI 1790990505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in MD · D0056686
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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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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Advanced Eye Care Medical Center, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Advanced Eye Care Medical Center, PA, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Renee Bovelle, M.D.
Ophthalmology
NPI 1588732424
12200 ANNAPOLIS RD SUITE 116
Glenn Dale, MD 20769
(301) 805-4664
✔ PECOS✔ Accepts MedicareSame address
Monica Allen, M.D.
Ophthalmology
NPI 1164460283
3650 STEVE REYNOLDS BLVD. KAISER PERMANENTE GWINNETT MEDICAL CENTER
Duluth, GA 30096
(313) 577-8900
✔ PECOS✔ Accepts Medicare535 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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, PA's NPI number?

The NPI number for Advanced Eye Care Medical Center, PA is 1790990505. It was assigned to this organization in the NPPES registry on May 14, 2007.

Where is Advanced Eye Care Medical Center, PA located?

Advanced Eye Care Medical Center, PA 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, PA's specialty?

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

Is Advanced Eye Care Medical Center, PA enrolled in Medicare?

Yes. Advanced Eye Care Medical Center, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Advanced Eye Care Medical Center, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Ophthalmology, reassign their Medicare billing to Advanced Eye Care Medical Center, PA. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Advanced Eye Care Medical Center, PA was last updated on May 23, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.