Individual provider Active NPI

Paula Laroche, O.D.

  • Optometrist
  • Bennington, VT
National Provider Identifier
1669427407
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
030-0000310 Issued in VT
Practice address
322 Dewey St
Bennington, VT 05201-2225
Phone
(802) 447-8700
Fax
(802) 447-1500
NPI assigned
May 23, 2006
Last updated
Mar 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 030-0000310 VT Primary

Addresses

Primary practice location

322 Dewey St
Bennington, VT 05201-2225

Mailing address

322 Dewey St
Bennington, VT 05201-2225
Phone (802) 447-8700

Other identifiers 7

IdentifierTypeStateIssuer
02360947MedicaidNY
10063061OtherVTCDPHP
361194OtherVTMVP
OVN2992MedicaidVT
410049539OtherVTRR MCRP
59302OtherVTVTBS
0965940001OtherVTDMERC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100808000008 VT Practitioner - Optometry 4082747381 Reassigns benefits to 1 organization
I20210119000052 MA Practitioner - Optometry 4082747381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Waterloo - School of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Eyecare PCGroup PAC ID 1052301546, 11 clinicians

Practice addresses (Care Compare)

322 Dewey St
Bennington, VT 05201-2225
Phone (802) 447-8700

77 Hospital Ave
North Adams, MA 01247-2550
Phone (413) 664-6736

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030-0000310VTMDOptometrist
4389MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eyecare PC Optometrist CurrentSince Sep 12, 2001 Accepting new patients
Advanced Eyecare, PC Past Accepting new patients
Advanced Eyecare, PC Past Accepting new patients

Locations

77 Hospital Ave
North Adams, MA 01247
Phone (413) 346-4242

77 Hospital Ave
Ste 110
North Adams, MA 01247
Phone (413) 664-6736

322 Dewey St
Bennington, VT 05201
Phone (802) 447-8700

5222 Main St
Manchestr Ctr, VT 05255
Phone (802) 366-8050

Organizations & group practices 3

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1669427407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 DEWEY ST",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052012225",
            "telephone_number": "802-447-8700",
            "fax_number": "802-447-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 DEWEY ST",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052012225",
            "telephone_number": "802-447-8700",
            "fax_number": "802-447-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROCHE",
        "first_name": "PAULA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030-0000310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02360947",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10063061",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "361194",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN2992",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCRP",
            "identifier": "410049539",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VTBS",
            "identifier": "59302",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0965940001",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bennington, VT

Sources for this page

Verify at the official NPI Registry.