Individual provider Active NPI

Renee Theroux Lynch, OD

  • Optometrist
  • Portsmouth, NH
National Provider Identifier
1083066005
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0944 Issued in NH
Practice address
155 Borthwick Ave Ste 200E
Portsmouth, NH 03801-4184
Phone
(603) 436-1773
Fax
(603) 501-7867
NPI assigned
Jul 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003206 PA
Optometrist 152W00000X 0944 NH Primary

Addresses

Primary practice location

155 Borthwick Ave Ste 200E
Portsmouth, NH 03801-4184

Mailing address

155 Borthwick Ave Ste 200E
Portsmouth, NH 03801-4184
Phone (603) 436-1773

Other identifiers 1

IdentifierTypeStateIssuer
3075455MedicaidNH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rtheroux@eyesightnh.emadirect.md Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20170712003302 NH Practitioner - Optometry 1951670561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyesight Ophthalmic Services PLLCGroup PAC ID 3971588609, 16 clinicians

Practice addresses (Care Compare)

155 Borthwick Ave
Suite 200E
Portsmouth, NH 03801-7156
Phone (603) 436-1773

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0944NHMDAddiction (Substance Use Disorder) Counselor
OEG003206PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyesight Ophthalmic Services PLLC Optometrist CurrentSince Jun 5, 2017 Accepting new patients

Locations

192 Water St
Exeter, NH 03833
Phone (603) 778-1133

155 Borthwick Ave
Ste 200E
Portsmouth, NH 03801

267 Route 108
Somersworth, NH 03878
Phone (603) 692-7500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1083066005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 BORTHWICK AVE STE 200E",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038014184",
            "telephone_number": "603-436-1773",
            "fax_number": "603-501-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 BORTHWICK AVE STE 200E",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038014184",
            "telephone_number": "603-436-1773",
            "fax_number": "603-501-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "RENEE",
        "middle_name": "THEROUX",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-02",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003206",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "0944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3075455",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rtheroux@eyesightnh.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "155 Borthwick Ave Ste 200E",
            "city": "Portsmouth",
            "state": "NH",
            "country_code": "US",
            "postal_code": "038014184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.