Individual provider Active NPI

John D Corrow, O.D.

  • Optometrist
  • Providence, RI
National Provider Identifier
1720095953
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODTA00502 Issued in RI
Practice address
780 North Main St.
Providence, RI 02904
Phone
(401) 331-2020
NPI assigned
Aug 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODTA00502 RI Primary

Addresses

Primary practice location

780 North Main St.
Providence, RI 02904

Mailing address

780 North Main St.
Providence, RI 02904
Phone (401) 331-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20041004000248 RI Practitioner - Optometry 8022077312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Rhode Island Professional PCGroup PAC ID 3870966369, 9 clinicians

Practice addresses (Care Compare)

2 Dexter St
Pawtucket, RI 02860-2996
Phone (401) 723-9540

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODTA00502RIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Eye Care Associates Optometrist CurrentSince Jan 4, 2005 Accepting new patients
Aeg Rhode Island Professional, PC Optometrist CurrentSince Dec 8, 2023 Accepting new patients
Ezra L. Galler, M.D., LTD. Optometrist PastSince Jul 1, 2001 Accepting new patients

Locations

2 Dexter St
Pawtucket, RI 02860
Phone (401) 723-9540

780 N Main St
Providence, RI 02904
Phone (401) 331-1108

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720095953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 NORTH MAIN ST.",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02904",
            "telephone_number": "401-331-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 NORTH MAIN ST.",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02904",
            "telephone_number": "401-331-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORROW",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTA00502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.