Aeg Rhode Island Professional, PC

Organization Active NPI Optometrist · Pawtucket, RI

NPI 1730898263 · NPPES record last updated Apr 4, 2025

Key facts

NPI
1730898263
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
AEG RHODE ISLAND PROFESSIONAL, PC
Practice address
2 Dexter St
Pawtucket, RI 02860-2996
Phone
(401) 723-9540
Fax
(314) 741-4947
NPI assigned
Nov 23, 2022
Organization subpart
No

Authorized official

Name
Jonathan Kaplan, OD
Title
Owner
Phone
(618) 462-9818

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in RI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230303000711 RI Part B Supplier - Clinic/Group Practice 3870966369 Receives reassigned benefits from 10 practitioners
Practice locations: Providence, RI; Pawtucket, RI

National Provider Directory

Locations

2 Dexter St
Ste 3
Pawtucket, RI 02860

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X Yes

Addresses

Primary practice location

2 Dexter St
Pawtucket, RI 02860-2996

Mailing address

111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (618) 462-9818

Other providers in Pawtucket, RI

All providers in Pawtucket, RI · Optometrist in Rhode Island

Sources for this page

Verify at the official NPI Registry.