John D Corrow, O.D.
Individual provider Active NPI Optometrist · Providence, RI
NPI 1720095953 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720095953
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- ODTA00502 (RI)
- Practice address
- 780 North Main St.
Providence, RI 02904 - Phone
- (401) 331-2020
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aeg Rhode Island Professional PC
Practice addresses (Care Compare)
2 Dexter St
Pawtucket, RI 02860-2996
Phone (401) 723-9540
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041004000248 | RI | Practitioner - Optometry | 8022077312 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ODTA00502 | RI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aeg Rhode Island Professional, PC | Optometrist | Current |
Accepting new patients |
| Advanced Eye Care Associates | Optometrist | Current |
Accepting new patients |
| Ezra L. Galler, M.D., LTD. | Optometrist | Past |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | ODTA00502 | RI | Yes |
Addresses
Primary practice location
780 North Main St.
Providence, RI 02904
Mailing address
780 North Main St.
Providence, RI 02904
Phone (401) 331-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9003624 | Medicaid | RI |
Other providers in Providence, RI
- Rebecca Lee Corrente
- Frank Corrigan
- Ingrid Cecilia Corrigan
- Jacqueline Corrigan
- Carl D Corrow
- Ashley Corsetti
- Francesca Corsinetti
- Mark Cort
- Emma Gabriella Cortes
- Shelley Cortese
All providers in Providence, RI · Optometrist in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.