Thomas G. Brelage, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

934DT Issued in KY

Practice address

206 W John Fitch Ave
Bardstown, KY 40004-1115

Phone

(502) 348-1107

Fax

(502) 348-0294

NPI assigned

Jul 21, 2006

Last updated

Nov 21, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in KY

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

Indiana University - School of Optometry, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pec Holding PLLCGroup PAC ID 6901823590, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Pec Holding, PLLC

  dba River City Eye Care

  • Optometrist
  • Louisville, KY
  • NPI 1609096247
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1083635676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 W JOHN FITCH AVE",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400041115",
            "telephone_number": "502-348-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W JOHN FITCH AVE",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400041115",
            "telephone_number": "502-348-1107",
            "fax_number": "502-348-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRELAGE",
        "first_name": "THOMAS",
        "middle_name": "G.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "934DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000050702",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLOCK VISION",
            "identifier": "911185",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1103277",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77009348",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Elizabeth Boyd, CF-SLP
• Paulette Braden-Korody
• Amanda Marie Bradford-Kenney, LCSW
• Tyler Bradley, FNMP
• Leslie Marie Brauner, APRN
• Dana M. Brockman, APRN
• Tammy Reid Brooks, P.T.
• Kaleena Marie Brown, MS, LPAT, ATR-BC
• Kersten Brown, RBT
• Shannen Brown, MS, ATC, LAT

• Optometrist in Bardstown, KY
• Providers in Bardstown, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.