VAN MAI MATTISON OD
NPI 1912492919
Optometrist in Leesburg, FL

Q: What is Van Mattison's NPI number?

The NPI number for Van Mattison is 1912492919. It was assigned to this individual provider in the NPPES registry on June 22, 2018. The provider is also known as Van Mai Vu Od.

Q: What is Van Mattison's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Van Mattison was last updated on July 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since June 22, 2018PECOS EnrolledAccepts Medicare Assignment

112 E DIXIE AVE, LEESBURG, FL 34748(352) 787-1956 Get Directions Write a Review

NPPES record last updated: July 25, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 18, 2022, Oct 23, 2019, May 22, 2019 and 1 more (4 updates tracked since 2018).

On this page

About Van Mai Mattison Od NPPES

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

VAN MAI MATTISON OD (NPI 1912492919) is an individual optometrist in Leesburg, Florida, licensed in Florida (OPC5557) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS and is a graduate of Southern California College Of Optometry (2018).

NPPES Registry Identity

NPI1912492919

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameVAN MAI MATTISONCredential: OD

Location Address112 E DIXIE AVELeesburg, FL 34748-6350

Mailing Address112 E Dixie AveLeesburg, FL 34748-6350 · (321) 754-0581

Phone(352) 787-1956

Sole ProprietorNo

Medical School CMSSouthern California College Of OptometryGraduated 2018

Enumeration DateJune 22, 2018

Last NPPES UpdateJuly 25, 20254 updates tracked since enumeration

NPPES CertifiedJuly 25, 2025

✔ NPI 1912492919 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 FL · OPC5557

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.

112 E DIXIE AVE, Leesburg, FL 34748

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Other Names 1

Former Name (1)Van Mai Vu Od

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Van Mai Mattison Od 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 ID1951635093

PECOS Enrollment IDI20190625000057

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.

Medicare Billing Reassignments

Medicare enrollment records show Van Mattison reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Coren Eye Group PLLC

Same address

Optometrist

112 E DIXIE AVE
Leesburg, FL 34748

Reassigned Medicare billing, Florida enrollment
2 clinicians in this Medicare group

NPI 1588182562 (352) 787-1956

Aeg Florida Professional PLLC

103 mi

Optometrist

4788 HODGES BLVD STE 205
Jacksonville, FL 32224

Reassigned Medicare billing, Florida enrollment
110 clinicians in this Medicare group

NPI 1164156246 (904) 992-9991

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

Areas of Expertise CMS Part B claims 10

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 intermediate testing 92082

An exam of the visual field with intermediate testing is a procedure that checks your peripheral (side) vision. It helps to identify blind spots which could be a sign of eye diseases. This non-invasive test is painless and quick.

155 services154 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.

150 services146 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.

134 services125 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.

73 services57 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.

41 services33 patients

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.

40 services40 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34748 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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 6

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

ROBERT S SIMON OD

Optometrist