Peter Douglas Paradis, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT820 Issued in ME

Practice address

216 Main St
Waterville, ME 04901-6116

Phone

(207) 872-2797

Fax

(207) 872-2793

NPI assigned

May 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in ME

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

Specialty

Optometry

Education

New England College of Optometry, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kennebec Eyecare PAGroup PAC ID 6406877703, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kennebec Eyecare PA

  • Optometrist
  • Waterville, ME
  • NPI 1659462067
  Medicare reassignment Care Compare group NPD Authorized official
• Vision Care of Maine LLC

  • Ambulatory Surgical Clinic/Center
  • Bangor, ME
  • NPI 1275629081
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1912900309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 MAIN ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049016116",
            "telephone_number": "207-872-2797",
            "fax_number": "207-872-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 MAIN ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049016116",
            "telephone_number": "207-872-2797",
            "fax_number": "207-872-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARADIS",
        "first_name": "PETER",
        "middle_name": "DOUGLAS",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "249080099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "MN2200",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "025801",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "M24029",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2023127",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stephanie Pare
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• Optometrist in Waterville, ME
• Providers in Waterville, ME by specialty
• Optometrist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.