Individual provider Active NPI

James P Theroux, O.D.

  • Optometrist
  • Woonsocket, RI
National Provider Identifier
1326074972
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODTG00410 Issued in RI
Practice address
166 Cass Ave
Woonsocket, RI 02895-4712
Phone
(401) 769-2511
Fax
(401) 769-7696
NPI assigned
Jun 24, 2006
Last updated
Sep 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 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 ODTG00410 RI Primary

Addresses

Primary practice location

166 Cass Ave
Woonsocket, RI 02895-4712

Mailing address

166 Cass Ave Unit 1
Woonsocket, RI 02895-4712
Phone (401) 769-2511

Other identifiers 1

IdentifierTypeStateIssuer
7000260MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20100612000042 RI Practitioner - Optometry 5890825160 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Koch Eye Associates LLPGroup PAC ID 1153213921, 28 clinicians

Practice addresses (Care Compare)

166 Cass Ave
Unit 1
Woonsocket, RI 02895-4712
Phone (401) 769-2511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODTG00410RIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Health Associates of Rhode Island Inc CurrentSince Sep 1, 2015 Accepting new patients
Eye Health Associates of Rhode Island Inc Optometrist CurrentSince Sep 1, 2015 Accepting new patients
Koch Eye Associates LLP Optometrist CurrentSince Jul 19, 1987 Accepting new patients
Koch Eye Associates, LLP Optometrist CurrentSince Jul 19, 1987 Accepting new patients
Wickford Optical, LLC PastSince Feb 14, 1996 Accepting new patients
Koch Eye Associates LLP Optometrist Past Accepting new patients

Locations

51 State Rd
North Dartmouth, MA 02747
Phone (508) 994-1400

1404 Atwood Ave
Johnston, RI 02919
Phone (401) 943-6000

73 Valley Rd
Middletown, RI 02842
Phone (401) 289-2170

7805 Post Rd
North Kingstown, RI 02852
Phone (401) 294-1010

20 Hampton Way
Ste 1A
Wakefield, RI 02879
Phone (401) 783-7009

566 Toll Gate Rd
Warwick, RI 02886
Phone (401) 732-1180

618 Toll Gate Rd
Warwick, RI 02886
Phone (401) 239-1800

166 Cass Ave
Woonsocket, RI 02895
Phone (401) 767-3600

166 Cass Ave
Unit 1
Woonsocket, RI 02895
Phone (401) 769-2511

Organizations & group practices 6

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1326074972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 CASS AVE UNIT 1",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954712",
            "telephone_number": "401-769-2511",
            "fax_number": "401-769-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 CASS AVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954712",
            "telephone_number": "401-769-2511",
            "fax_number": "401-769-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEROUX",
        "first_name": "JAMES",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTG00410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000260",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.