Individual provider Active NPI

Charles Thomas, O.D.

  • Optometrist
  • Amite, LA
National Provider Identifier
1497715619
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
977254T Issued in LA
Practice address
420 N 2ND St
Amite, LA 70422-2420
Phone
(985) 748-8750
Fax
(985) 748-8795
NPI assigned
Mar 23, 2006
Last updated
Oct 3, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 977254T LA Primary

Addresses

Primary practice location

420 N 2ND St
Amite, LA 70422-2420

Mailing address

420 N 2ND St
Amite, LA 70422-2420
Phone (985) 748-8750

Other identifiers 1

IdentifierTypeStateIssuer
1351032MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20040604000028 LA Practitioner - Optometry 8628050556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Precision Optical of Hammond, Inc.Group PAC ID 5294861019, 3 clinicians
Tiger Vision, L.L.C.Group PAC ID 0840292850, 10 clinicians

Practice addresses (Care Compare)

420 N 2ND St
Amite, LA 70422-2420
Phone (985) 748-8750

42373 Pelican Professional Park
Hammond, LA 70403-2412
Phone (985) 542-5624

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
977LAMDAddiction (Substance Use Disorder) Counselor
977254TLAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tiger Vision, L.L.C. CurrentSince Dec 13, 2006 Accepting new patients
Precision Optical of Hammond, Inc. Optometrist CurrentSince Feb 1, 2010 Accepting new patients

Locations

420 N 2nd St
Amite, LA 70422
Phone (985) 340-7868

10423 Old Hammond Hwy
Baton Rouge, LA 70816
Phone (225) 923-0139

42373 Pelican Professional Park
Hammond, LA 70403
Phone (985) 542-5624

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1497715619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N 2ND ST",
            "city": "AMITE",
            "state": "LA",
            "postal_code": "704222420",
            "telephone_number": "985-748-8750",
            "fax_number": "985-748-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N 2ND ST",
            "city": "AMITE",
            "state": "LA",
            "postal_code": "704222420",
            "telephone_number": "985-748-8750",
            "fax_number": "985-748-8795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CHARLES",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "977254T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1351032",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amite, LA

Sources for this page

Verify at the official NPI Registry.