Robert Mitchell Thacker, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODTA00456 Issued in RI

Practice address

1466 Broad St
Providence, RI 02905-2836

Phone

(401) 941-6221

Fax

(401) 941-6227

NPI assigned

May 2, 2006

Last updated

Sep 19, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

George D Bertherman,O.D., Inc.Group PAC ID 1355441858, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• George D. Bertherman,O.D., Inc.

  • Optometrist
  • Providence, RI
  • NPI 1316072143
  Medicare reassignment Care Compare group NPD
• Ashley R. Folgo Psychiatric Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Warwick, RI
  • NPI 1952848889
  NPD (past)
• Strand Optical Co. Inc.

  • Eyewear Supplier
  • Cranston, RI
  • NPI 1639219330
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1003874991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 FISH HILL RD",
            "city": "WEST GREENWICH",
            "state": "RI",
            "postal_code": "028172209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1466 BROAD ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052836",
            "telephone_number": "401-941-6221",
            "fax_number": "401-941-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "ROBERT",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTA00456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anant Raj Tewari, MD
• Geetika Tewary, M.D.
• Textron Chamber of Commerse Academy
• Textron Chamber of Commerse Academy
• Katherine Tezanos, PHD
• Jinen Arun Thakkar, M.D.
• Keya Thakkar, PA-C
• Kishan Thakkar
• Rupal H Thakor, MD
• Sweta Thakur, DDS

• Optometrist in Providence, RI
• Providers in Providence, RI by specialty
• Optometrist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.