Individual provider Active NPI

Nicholas A Pittman, OD

  • Optometrist
  • Bradford, VT
National Provider Identifier
1134552755
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VT0300097803 Issued in VT
Practice address
331 Upper PLN Unit 2
Bradford, VT 05033-9207
Phone
(802) 222-4543
NPI assigned
Aug 19, 2013
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 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 VT0300097803 VT Primary

Addresses

Primary practice location

331 Upper PLN Unit 2
Bradford, VT 05033-9207

Mailing address

PO Box 325
Bradford, VT 05033-0325
Phone (802) 222-4543

Other identifiers 1

IdentifierTypeStateIssuer
1376282053OtherORGANIZATION NPI (TYPE II)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20131202001408 VT Practitioner - Optometry 3072749738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

331 Upper PLN
Bradford, VT 05033-9207
Phone (802) 222-4543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0886NHMDAddiction (Substance Use Disorder) Counselor
VT0300097803VTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionary Eye Associates LLC Optometrist CurrentSince Jun 1, 2022 Accepting new patients
Dufour Vision Care PLLC Optometrist PastSince Feb 23, 2025 Accepting new patients

Locations

331 Upper Pln
Bradford, VT 05033
Phone (802) 222-4543

331 Upper Pln
Unit 2
Bradford, VT 05033
Phone (802) 222-4543

Organizations & group practices 2

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": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1134552755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 325",
            "city": "BRADFORD",
            "state": "VT",
            "postal_code": "050330325",
            "telephone_number": "802-222-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 UPPER PLN UNIT 2",
            "city": "BRADFORD",
            "state": "VT",
            "postal_code": "050339207",
            "telephone_number": "802-222-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "NICHOLAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-19",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "VT0300097803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATION NPI (TYPE II)",
            "identifier": "1376282053",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradford, VT

Sources for this page

Verify at the official NPI Registry.