Individual provider Active NPI

Thomas P. Nadeau, O.D.

  • Optometrist
  • Boothbay Harbor, ME
National Provider Identifier
1275520975
Registry record updated Aug 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT603 Issued in ME
Practice address
145 Townsend Ave
Boothbay Harbor, ME 04538-1845
Phone
(207) 633-3035
Fax
(207) 633-6079
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT603 ME Primary

Addresses

Primary practice location

145 Townsend Ave
Boothbay Harbor, ME 04538-1845

Mailing address

145 Townsend Ave
P.O. Box 455
Boothbay Harbor, ME 04538-1834
Phone (207) 633-3035

Other identifiers 1

IdentifierTypeStateIssuer
129790000MedicaidME

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
I20060330000428 ME Practitioner - Optometry 5092723122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1977
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

145 Townsend Ave
Boothbay Harbor, ME 04538-1845
Phone (207) 633-3035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas P. Nadeau,O.D.,P.C. Optometrist CurrentSince May 3, 2016 Accepting new patients

Locations

145 Townsend Ave
Boothbay Harbor, ME 04538
Phone (207) 633-3035

165 Bath Rd
Wiscasset, ME 04578

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250726400000",
    "number": "1275520975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 TOWNSEND AVE",
            "address_2": "P.O. BOX 455",
            "city": "BOOTHBAY HARBOR",
            "state": "ME",
            "postal_code": "045381834",
            "telephone_number": "207-633-3035",
            "fax_number": "207-633-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 TOWNSEND AVE",
            "city": "BOOTHBAY HARBOR",
            "state": "ME",
            "postal_code": "045381845",
            "telephone_number": "207-633-3035",
            "fax_number": "207-633-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADEAU",
        "first_name": "THOMAS",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2009-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129790000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boothbay Harbor, ME

Sources for this page

Verify at the official NPI Registry.