NPIMap

Organization Active NPI

Bath Optometric Associates, P.C.

  • Optometrist
  • Bath, ME
National Provider Identifier
1700068137
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
571T Issued in ME
Legal business name
BATH OPTOMETRIC ASSOCIATES, P.C.
Practice address
126 Front St
Bath, ME 04530-2607
Phone
(207) 443-5012
Fax
(207) 442-8661
NPI assigned
Nov 27, 2007
Last updated
Aug 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Authorized official

Name
Dr. Louis Francis Ricciardone Jr., O.D.NPI 1750461216
Title
President/Owner
Phone
(207) 443-5012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 571T ME Primary

Addresses

Primary practice location

126 Front St
Bath, ME 04530-2607

Mailing address

126 Front St
Bath, ME 04530-2607
Phone (207) 443-5012

Other identifiers 5

IdentifierTypeStateIssuer
M52290OtherMECIGNA
000468OtherMEANTHEM
MNT 267OtherMEHARVARD PILGRIM
1041908OtherMEAETNA
100410020MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080204000458 ME Part B Supplier - Clinic/Group Practice 7719069319 Receives reassigned benefits from 2 practitioners
Practice locations: Bath, ME

National Provider Directory

National Provider Directory

Locations

126 Front St
Bath, ME 04530
Phone (207) 443-5012

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280707200000",
    "number": "1700068137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 FRONT ST",
            "city": "BATH",
            "state": "ME",
            "postal_code": "045302607",
            "telephone_number": "207-443-5012",
            "fax_number": "207-442-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 FRONT ST",
            "city": "BATH",
            "state": "ME",
            "postal_code": "045302607",
            "telephone_number": "207-443-5012",
            "fax_number": "207-442-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BATH OPTOMETRIC ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2010-08-02",
        "status": "A",
        "authorized_official_last_name": "RICCIARDONE",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "207-443-5012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "571T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "M52290",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000468",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "MNT 267",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1041908",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100410020",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.