Active NPI
Donald Rene Carbonneau, OD
- Optometrist
- Augusta, ME
National Provider Identifier
1679600258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT732
- Practice address
- 313 Water St
Augusta, ME 04330-4619 - Phone
- (207) 623-8622
- NPI assigned
- Feb 28, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT732 | ME | Primary |
Addresses
Primary practice location
313 Water St
Augusta, ME 04330-4619
Mailing address
313 Water St
Augusta, ME 04330-4619
Phone (207) 623-8622
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000749 | Other | ME | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050722000228 | ME | Practitioner - Optometry | 8022045939 | Practice locations: Augusta, ME |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- New England College of Optometry, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
313 Water St
Augusta, ME 04330-4665
Phone (207) 623-8622
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204070400000",
"number": "1679600258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 WATER ST",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043304619",
"telephone_number": "207-623-8622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 WATER ST",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043304619",
"telephone_number": "207-623-8622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARBONNEAU",
"first_name": "DONALD",
"middle_name": "RENE",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2008-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ME",
"license": "OPT732",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000749",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Augusta, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.