Individual provider Active NPI

Philip Lee Sutherland, O.D.

  • Optometrist
  • Nashua, NH
National Provider Identifier
1720083819
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0502 Issued in NH
Practice address
5 Coliseum Ave
Nashua, NH 03063-3292
Phone
(603) 882-9800
Fax
(603) 882-0556
NPI assigned
Jun 16, 2005
Last updated
Aug 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0502 NH Primary

Addresses

Primary practice location

5 Coliseum Ave
Nashua, NH 03063-3292

Mailing address

5 Coliseum Ave
Nashua, NH 03063-3292
Phone (603) 882-9800

Other identifiers 1

IdentifierTypeStateIssuer
30001760MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20051019000925 NH Practitioner - Optometry 0840216883 Reassigns benefits to 1 organization

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
Group practices
Nashua Eye Associates PAGroup PAC ID 8628961216, 19 clinicians

Practice addresses (Care Compare)

5 Coliseum Ave
Nashua, NH 03063-3206

5 Coliseum Ave
Nashua, NH 03063-3292
Phone (603) 882-9800

Merit-based Incentive Payment System (MIPS)

Final score
88.97 of 100Reported as group
Quality
86.44
Promoting interoperability
100
Improvement activities
40
Cost
76.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
502NHMDMental Health Counselor
3276MAMDSpeech-Language Pathologist
0502NHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nashua Eye Associates, P.a. Optometrist CurrentSince Aug 21, 1989 Accepting new patients

Locations

30 Lowell Rd
Hudson, NH 03051
Phone (603) 598-6400

555 Nashua St
Milford, NH 03055
Phone (603) 672-8800

5 Coliseum Ave
Nashua, NH 03063
Phone (603) 881-7141

5 Coliseum Ave
Ste 101
Nashua, NH 03063
Phone (603) 882-9800

Interoperability endpoints

  • Direct secure messaging: psutherland@nashuaeye.direct.eyemdemr.com

Organizations & group practices 1

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1720083819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 COLISEUM AVE",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030633292",
            "telephone_number": "603-882-9800",
            "fax_number": "603-882-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 COLISEUM AVE",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030633292",
            "telephone_number": "603-882-9800",
            "fax_number": "603-882-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "PHILIP",
        "middle_name": "LEE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NH",
            "license": "0502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30001760",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.