John E Thordsen Jr., MD

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

2011-00308 Issued in NC

Practice address

4414 Lake Boone TRL Ste 302
Raleigh, NC 27607-7514

Phone

(197) 828-0389

Fax

(919) 782-8189

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Ponce School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Retina Associates, PLLCGroup PAC ID 3870498876, 18 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Retina Associates, PLLC

  dba North Carolina Retina Associates, PC

  • Retina Specialist (Ophthalmology) Physician
  • Raleigh, NC
  • NPI 1760408397
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1073659769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL",
            "address_2": "302",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077513",
            "telephone_number": "919-782-8038",
            "fax_number": "919-782-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 302",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077514",
            "telephone_number": "197-828-0389",
            "fax_number": "919-782-8189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORDSEN",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2011-00308",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NC",
            "license": "2011-00308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jthordsen@northcarolinaretina.intellechartdirect.net",
            "affiliation": "N",
            "address_1": "4414 Lake Boone Trl Ste 302",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Timothy B Thompson, MD
• Victoria Thompson
• Marlee Cadwell Thomsen, MSW, LCSWA
• Dana Sroka Thomson, DPT
• Timothy Thorb
• Sandra Kaye Thore, D.M.D.
• Alacyia Thorne
• Lori A. Thorne, LCSW
• Shayla Thorne
• John Thornsberry, PHARMD

• Retina Specialist (Ophthalmology) Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Retina Specialist (Ophthalmology) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.