David Tetrault, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

AZ0806 Issued in AZ

Practice address

2894 N Campbell Ave
Tucson, AZ 85719-2876

Phone

(520) 323-3937

Fax

(520) 323-3938

NPI assigned

Aug 31, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Illinois College of Optometry at Chicago, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John H McDougall OD Arizona PCGroup PAC ID 3274880117, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• John H McDougall OD Arizona PC

  • Optometrist
  • Fountain Hills, AZ
  • NPI 1851882179
  Medicare reassignment Care Compare group NPD
• Alvernon Optical, Inc.

  • Eyewear Supplier
  • Tucson, AZ
  • NPI 1730206004
  NPD (past)
• Alvernon Optical, Inc.

  • Eyewear Supplier
  • Tucson, AZ
  • NPI 1972614584
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1114038692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 N ALVERNON WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111958",
            "telephone_number": "520-327-6215",
            "fax_number": "520-327-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2894 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857192876",
            "telephone_number": "520-323-3937",
            "fax_number": "520-323-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETRAULT",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "AZ0806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046070",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phoebe Teskey
• Jenna Teso, LCSW
• Christina Valley Testa, MA
• Eric Testa
• Courtney Tetlow
• Carol A Tetrick, RN
• Stephanie L Teubner, PMHNP, RN
• Kai Rou Tey, M.D.
• TG Oxygen LLC
• Hoang Minh Thai, M.D.

• Optometrist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.