Active NPI
Peter T. Eudenbach, O.D.
- Optometrist
- Middletown, RI
National Provider Identifier
1720490980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- ODTA00287
- Practice address
- 58 E Main Rd
Middletown, RI 02842-4912 - Phone
- (401) 846-1620
- NPI assigned
- May 22, 2014
- Last updated
- May 22, 2014
- 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 | ODTA00287 | RI | Primary |
Addresses
Primary practice location
58 E Main Rd
Middletown, RI 02842-4912
Mailing address
416 Gibbs Ave
Newport, RI 02840-3327
Phone (401) 847-0961
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ODTA00287 | RI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400716800000",
"number": "1720490980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 GIBBS AVE",
"city": "NEWPORT",
"state": "RI",
"postal_code": "028403327",
"telephone_number": "401-847-0961",
"fax_number": "401-847-6301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "58 E MAIN RD",
"city": "MIDDLETOWN",
"state": "RI",
"postal_code": "028424912",
"telephone_number": "401-846-1620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EUDENBACH",
"first_name": "PETER",
"middle_name": "T.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-22",
"last_updated": "2014-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "RI",
"license": "ODTA00287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, RI
- Empire Vision Center Inc (Vision World)
- Rebecca English, LMHC
- Marisa Erazo, PA-C
- Essential Bodywork (Deeper Dive Wellness)
- Keryann Estrela, DNP
- Evan MK Garrett Family Medicine PC
- Samantha Ewart, MSW, LCSW
- Eye Health Associates of Rhode Island Inc
- Eye Health Associates of Rhode Island Inc
- Eye Health Vision Center of Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.