Active NPI
Robert Paul Duquette, OPTOMETRIST
- Optometrist
- Swansea, MA
National Provider Identifier
1639165186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2512
- Practice address
- 1162 Grand Army Hwy
Swansea, MA 02777-4224 - Phone
- (508) 676-3036
- Fax
- (508) 676-3036
- NPI assigned
- Sep 21, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2512 | MA | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 2512 | MA | |
| Low Vision Rehabilitation Optometrist | 152WL0500X | 2512 | MA |
Addresses
Primary practice location
1162 Grand Army Hwy
Swansea, MA 02777-4224
Mailing address
1162 Grand Army Hwy
Swansea, MA 02777-4224
Phone (508) 676-3036
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 401194 | Other | RI | RI BLUE CHIP |
| RD00407 | Other | MA | RI WELFARE |
| 152075 | Other | MA | HARVARD PILGRIM |
| 201004 | Other | MA | UNITED HEALTHCARE |
| 72397 | Other | MA | RI BLUE CROSS |
| DOC19815 | Other | MA | NEIGHBORHOOD HEALTH PLAN |
| 000000024776 | Other | MA | BOSTON MEDICAL CENTER |
| 0327875 | Medicaid | MA | |
| 0459020001 | Other | MA | DMERC |
| 76499 | Other | MA | TUFTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2512 | MA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189555200000",
"number": "1639165186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1162 GRAND ARMY HWY",
"city": "SWANSEA",
"state": "MA",
"postal_code": "027774224",
"telephone_number": "508-676-3036",
"fax_number": "508-676-3036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1162 GRAND ARMY HWY",
"city": "SWANSEA",
"state": "MA",
"postal_code": "027774224",
"telephone_number": "508-676-3036",
"fax_number": "508-676-3036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUQUETTE",
"first_name": "ROBERT",
"middle_name": "PAUL",
"credential": "OPTOMETRIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2007-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MA",
"license": "2512",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "MA",
"license": "2512",
"primary": false
},
{
"code": "152WL0500X",
"taxonomy_group": "",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": "MA",
"license": "2512",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RI BLUE CHIP",
"identifier": "401194",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RI WELFARE",
"identifier": "RD00407",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "152075",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "201004",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RI BLUE CROSS",
"identifier": "72397",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "DOC19815",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOSTON MEDICAL CENTER",
"identifier": "000000024776",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0327875",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "0459020001",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "76499",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Swansea, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.