Active NPI 1326074972 Individual Practitioner Male Practitioner

Dr. James P Theroux , OD

Optometrist • Woonsocket, RI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. James Theroux, OD is a certified Optometrist practicing in Woonsocket, RI. With approximately 39 years of clinical experience since graduating from Southern College Of Optometry in 1987, Dr. Theroux delivers high-quality medical care to the local community at 166 CASS AVE.

Dr. Theroux is affiliated with Koch Eye Associates Llp and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient complete exam of visual system, photography of the retina, imaging of optic nerve. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

166 Cass Ave

Woonsocket, RI 028954712

Telephone 4017692511

Fax 4017697696

Associated Practice Facility / Clinic

🏢 Koch Eye Associates, Llp Facility NPI 1235534272

Medicare Profile & Education

Medical School

Southern College Of Optometry

Graduation Year

1987

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Woonsocket, RI

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

39 Yrs +20.3 yrs vs City Avg

City Avg: 18.7 Yrs

State Avg: 23.3 Yrs

Regional Practice Density

13 Specialists

Practicing in Woonsocket, RI (280 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

62.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Theroux (39 Years) 39 Yrs

Woonsocket Specialty Average (18.7 Years) 18.7 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	67	67	$283.00	$128.44
92250 Photography of the retina	36	36	$182.00	$37.47
92133 Imaging of optic nerve	16	14	$108.00	$35.84
92012 Established patient problem focused exam of visual system	14	12	$197.00	$90.87

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	56	56	$283.00	$131.70
92250 Photography of the retina	15	15	$182.00	$38.97
92133 Imaging of optic nerve	12	11	$108.00	$37.71

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	64	64	$269.00	$131.99
92250 Photography of the retina	11	11	$173.00	$38.52
92012 Established patient problem focused exam of visual system	11	11	$187.00	$93.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	130	130	$269.00	$134.55
92012 Established patient problem focused exam of visual system	50	43	$187.00	$95.39
92250 Photography of the retina	27	27	$173.00	$41.55
92133 Imaging of optic nerve	27	25	$102.00	$38.53
92083 Exam of visual field with extended testing	23	19	$138.00	$67.59
92134 Imaging of retina	12	12	$89.00	$43.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	217	217	$269.00	$133.75
92012 Established patient problem focused exam of visual system	65	55	$187.00	$93.99
92250 Photography of the retina	42	42	$173.00	$48.05
92133 Imaging of optic nerve	25	25	$102.00	$38.87
92083 Exam of visual field with extended testing	17	17	$138.00	$67.42
92020 Examination of cornea and iris using lens device and slit lamp	14	14	$57.00	$29.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	244	241	$269.00	$133.67
92012 Established patient problem focused exam of visual system	124	87	$187.00	$93.28
92250 Photography of the retina	68	67	$173.00	$53.41
92020 Examination of cornea and iris using lens device and slit lamp	42	38	$57.00	$29.15
92133 Imaging of optic nerve	40	40	$102.00	$38.84
92083 Exam of visual field with extended testing	27	27	$138.00	$67.95
92145 Measurement of corneal pressure	27	27	$39.00	$16.93
92004 New patient complete exam of visual system	16	16	$322.00	$159.39
92134 Imaging of retina	14	14	$89.00	$43.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	239	238	$268.70	$128.10
92012 Established patient problem focused exam of visual system	113	79	$186.81	$88.42
92250 Photography of the retina	77	75	$173.00	$58.07
92133 Imaging of optic nerve	26	25	$102.00	$38.38
83861 Microfluid analysis of tears	23	12	$45.00	$22.03
92083 Exam of visual field with extended testing	18	18	$138.00	$65.33
92134 Imaging of retina	17	16	$89.18	$42.45
92004 New patient complete exam of visual system	11	11	$322.00	$152.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	247	245	$260.00	$128.38
92012 Established patient problem focused exam of visual system	137	104	$180.00	$88.59
92250 Photography of the retina	113	112	$167.00	$68.68
92133 Imaging of optic nerve	30	29	$90.00	$38.59
92083 Exam of visual field with extended testing	30	30	$140.00	$66.84
83861 Microfluid analysis of tears	30	13	$45.00	$22.21
92020 Examination of cornea and iris using lens device and slit lamp	25	24	$50.00	$27.91
92134 Imaging of retina	15	15	$90.00	$42.60
67820 Removal of eyelashes using forceps	14	12	$142.86	$62.95

Medical Specialties & State Licenses

CMS Verified: 2022-09-21

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License RI ODTG00410

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

7000260 (RI)

Hospital & Practice Group Affiliations

Koch Eye Associates Llp

166 Cass Ave, Woonsocket, RI 028954712

Phone: 4017692511

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Dr. Vinh Tran , OD

Optometrist

NPI 1689128795

Doctor of Optometry

Dr. Eleftherios Alexandrou , MD

Ophthalmology

NPI 1912168352

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events

📍

Updated Business Mailing Address January 08, 2020

Registered at 166 CASS AVE UNIT 1, WOONSOCKET, RI 028954712 (Tel: 4017692511)

✅

NPI Profile Active May 04, 2017

NPI status registered as active in NPPES database

📍

Updated Business Mailing Address May 04, 2017

Registered at 175 PARAMOUNT DR, SUITE 203, RAYNHAM, MA 027671065 (Tel: 7743203040)

📍

Updated Practice Location May 04, 2017

Registered at 166 CASS AVE, WOONSOCKET, RI 028954712 (Tel: 4017692511)

👤

Provider Name / Credentials Updated May 04, 2017

Recorded as JAMES THEROUX, O.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 04, 2017

Optometrist (License #ODTG00410 in RI)

✅

NPI Profile Active September 25, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location September 25, 2015

Registered at 166 CASS AVE, WOONSOCKET, RI 028954712 (Tel: 4017692511)

📍

Updated Business Mailing Address September 25, 2015

Registered at 566 TOLL GATE RD, WARWICK, RI 028862716 (Tel: 4017384800)

👤

Provider Name / Credentials Updated September 25, 2015

Recorded as JAMES THEROUX, O.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 25, 2015

Optometrist (License #ODTG00410 in RI)

🟢

Initial NPI Registration & Enumeration June 24, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1326074972

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 24, 2006

Last Update: September 21, 2022

Sole Proprietor: No

Update or Correct Profile

Mailing Address

166 Cass Ave Unit 1

Woonsocket, RI 028954712

Phone: 4017692511

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.