Individual provider Active NPI

Pranjal Thakuria, MD

  • Ophthalmology Physician
  • Providence, RI
National Provider Identifier
1285830323
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD14427 Issued in RI
Practice address
150 E Manning St
Providence, RI 02906-5109
Phone
(401) 272-2020
NPI assigned
Jun 25, 2007
Last updated
May 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 2009-00806 NC
Ophthalmology Physician 207W00000X 57.009639 OH
Ophthalmology Physician 207W00000X MD60157794 WA
Ophthalmology Physician 207W00000X MD14427 RI Primary

Addresses

Primary practice location

150 E Manning St
Providence, RI 02906-5109

Mailing address

150 E Manning St
Providence, RI 02906-5109
Phone (216) 288-6940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080812000186 MA Practitioner - Ophthalmology 8022183912 Reassigns benefits to 1 organization
I20131209000312 RI Practitioner - Ophthalmology 8022183912 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Refocus Eye Health of Ri, LLCGroup PAC ID 3678940277, 17 clinicians

Practice addresses (Care Compare)

150 E Manning St
Providence, RI 02906-5109
Phone (401) 272-2020

235 Hanover St
Suite 201
Fall River, MA 02720-5299
Phone (508) 679-0150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57.009639OHMDOphthalmology Physician
MD60157794WAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Refocus Eye Health of Ri, LLC Ophthalmology CurrentSince Oct 10, 2022 Accepting new patients
Refocus Eye Health of Ri, LLC Ophthalmology CurrentSince Oct 10, 2022 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Sep 27, 2020 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Sep 27, 2020 Accepting new patients
Retina Consultants of Seattle, PC Past Accepting new patients

Locations

87 Grandview Ave
Ste B
Waterbury, CT 06708
Phone (203) 465-1424

235 Hanover St
Ste 201
Fall River, MA 02720
Phone (508) 679-0150

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

1 Hoppin St
Ste 202
Providence, RI 02903
Phone (401) 444-6551

150 E Manning St
Providence, RI 02906
Phone (401) 272-2020

1525 Wampanoag Trl
Ste 105
Riverside, RI 02915
Phone (401) 437-0500

55 Village Square Dr
Bldg 24
Wakefield, RI 02879
Phone (401) 272-2020

55 Village Square Dr
Ste 24
Wakefield, RI 02879
Phone (401) 272-2020

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1285830323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E MANNING ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065109",
            "telephone_number": "216-288-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E MANNING ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065109",
            "telephone_number": "401-272-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKURIA",
        "first_name": "PRANJAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2009-00806",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "57.009639",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD60157794",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "RI",
            "license": "MD14427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.