Individual provider Active NPI

Bradley N Trask, OD

  • Optometrist
  • Presque Isle, ME
National Provider Identifier
1083138960
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT989 Issued in ME
Practice address
173 Academy St
Presque Isle, ME 04769-3103
Phone
(207) 764-0376
Fax
(207) 764-7612
NPI assigned
Aug 1, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT989 ME Primary

Addresses

Primary practice location

173 Academy St
Presque Isle, ME 04769-3103

Mailing address

1 Ridgewood Dr
Bangor, ME 04401-2652
Phone (207) 945-6200

Other practice location 1

1 Ridgewood Dr
Bangor, ME 04401-2652
Phone (207) 945-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20171212002269 ME Practitioner - Optometry 1850659251 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

173 Academy St
Presque Isle, ME 04769-3103
Phone (207) 764-0376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT989MEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Care of Maine LLC Optometrist CurrentSince Oct 4, 2017 Accepting new patients
Vision Care of Maine Aroostook, LLC Optometrist CurrentSince Oct 4, 2017 Accepting new patients
Vision Care of Maine LLC CurrentSince Oct 4, 2017 Accepting new patients
Vision Care of Maine-Aroostook LLC Optometrist CurrentSince Oct 4, 2017 Accepting new patients
Vision Care of Maine, LLC Optometry Group Optometrist Past Accepting new patients

Locations

1 Ridgewood Dr
Bangor, ME 04401
Phone (207) 667-9690

173 Academy St
Presque Isle, ME 04769
Phone (207) 764-0376

Interoperability endpoints

  • Direct secure messaging: bradley.trask.p1@direct.visioncareofmaine.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083138960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RIDGEWOOD DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012652",
            "telephone_number": "207-945-6200",
            "fax_number": "207-990-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 ACADEMY ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693103",
            "telephone_number": "207-764-0376",
            "fax_number": "207-764-7612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Ridgewood Dr",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044012652",
            "country_code": "US",
            "telephone_number": "207-945-6200",
            "fax_number": "207-990-3015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRASK",
        "first_name": "BRADLEY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Presque Isle, ME

Sources for this page

Verify at the official NPI Registry.