Advanced Eyecare PC
Advanced Eyecare PC is a healthcare organization registered as Ophthalmology Physician in Bennington, VT, holding Type 2 (organization) NPI 1790739340 since 2006. The authorized official on file is Tracy Niles, Practice Administrator.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1790739340 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Advanced Eyecare PC |
| Practice address | 322 DEWEY ST, Bennington, VT, 05201 |
| Phone | 8024478700 |
| Fax | 8024471500 |
| Enumeration date | 2006-05-19 |
| Last updated in NPPES | 2020-07-21 |
Authorized official
| Name | Tracy Niles |
|---|---|
| Title | Practice Administrator |
| Phone | 8024478700 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 152W00000X | Optometrist | Secondary | — | VT |
| 207W00000X | Ophthalmology Physician | Secondary | — | MA |
| 207W00000X | Ophthalmology Physician | Primary | — | VT |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110072172A | Medicaid | MA | — |
| ADVA318-19924 | Other | VT | VTBS |
| ADVA318-19924 | Other | MA | VTBS |
| M16004 | Other | MA | MABS |
| M16004 | Other | VT | MABS |
| VN0966 | Medicaid | VT | — |
| 1059 | Other | VT | CDPHP |
| 200052887 | Other | MA | MVP |
| 614906 | Other | MA | TUFTS |
| 01794247 | Medicaid | NY | — |
| 1268 | Other | VT | HNE |
| 1059 | Other | MA | CDPHP |
| 1268 | Other | MA | HNE |
| 200052887 | Other | VT | MVP |
| VT0949 | Medicaid | VT | — |
| 614906 | Other | VT | TUFTS |
Copy-ready billing details
Provider: Advanced Eyecare PC NPI: 1790739340 Taxonomy: 207W00000X (Ophthalmology Physician) Address: 322 DEWEY ST, Bennington, VT, 05201
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1962456905 | Richard Provenzano | Individual | Ophthalmology Physician | Bennington, VT |
| 1417901356 | Stuart Duboff | Individual | Ophthalmology Physician | Bennington, VT |
| 1669427407 | Paula Laroche | Individual | Optometrist | Bennington, VT |
| 1194772491 | Erik Niemi | Individual | Ophthalmology Physician | Bennington, VT |
| 1043258262 | Michael Porter | Individual | Optometrist | Bennington, VT |
| 1821036088 | John Lapenta | Individual | Ophthalmology Physician | Bennington, VT |
| 1689939795 | Brett Smith | Individual | Ophthalmology Physician | Bennington, VT |
Verify this record
Cross-check NPI 1790739340 against the authoritative CMS record: view Advanced Eyecare PC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Advanced Eyecare PC?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2020-07-21.