Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Alisa Thavikulwat

Individual provider Ophthalmology Physician · NPI 1265827745

Alisa Thavikulwat is an Ophthalmology in Glenn Dale, Maryland. Graduated from University of Rochester School of Medicine and Dentistry in 2015, 11 years ago. Practices with Visionmd, LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
11
Trained at
University of Rochester School of Medicine and Dentistry
Licensed in
MD
In the registry since
2015

Practice location Address checks out

12150 Annapolis Rd Ste 111
Glenn Dale, MD 20769-9183
Phone: (301) 779-0844
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence D0087217 (MD)

Record details

NPI number1265827745
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 1, 2015
Last updated in NPPESSeptember 24, 2020
Certification dateSeptember 24, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPHTHALMOLOGY
Medical schoolUNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
Graduated 2015 (11 years in practice)
Group practice Visionmd, Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Glenn Dale