Active NPI
Timothy W Tolford, OD
- Optometrist
- Portland, ME
National Provider Identifier
1063401578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT637
- Practice address
- 770 Congress St
Portland, ME 04102-3323 - Phone
- (207) 772-8384
- Fax
- (207) 773-0020
- NPI assigned
- Oct 18, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT637 | ME | Primary |
Addresses
Primary practice location
770 Congress St
Portland, ME 04102-3323
Mailing address
PO Box 7487
Portland, ME 04112-7487
Phone (207) 885-8686
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 244810099 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Casco Bay Eyecare LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Eyewear Supplier
- Portland, ME
- NPI 1073688826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326758400000",
"number": "1063401578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7487",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041127487",
"telephone_number": "207-885-8686",
"fax_number": "207-883-7154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 CONGRESS ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023323",
"telephone_number": "207-772-8384",
"fax_number": "207-773-0020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLFORD",
"first_name": "TIMOTHY",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-18",
"last_updated": "2012-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ME",
"license": "OPT637",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "244810099",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.