Dr. James P Theroux , OD
Optometrist • Woonsocket, RI
166 Cass Ave
Woonsocket, RI 028954712
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
-
NPI assigned on June 24, 2006; this date does not establish years in practice.
-
Published CMS data list 133 Original Medicare Part B services in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Published rows only; this is not a quality measure.
-
Published Part B service records, 2024:
- 92014 — Established patient complete exam of visual system: 67 service units.
- 92250 — Photography of the retina: 36 service units.
- 92133 — Imaging of optic nerve: 16 service units.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Units differ by code; these are not visits or a measure of quality.
CPT® only copyright 2023 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2024). CPT notice
See all 4 records in the table · Guide: How to read Medicare Part B data
-
Published CMS data list 71 Medicare Part D prescriptions, including refills, in 2024.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Published rows only; this is not a quality measure.
-
Published Part D records, 2024:
- Latanoprost — 52 prescription fills, including refills.
- Brimonidine Tartrate — 19 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See the full table · Guide: How to read Medicare Part D prescriber data
-
Fewer Medicare Part B services than 75% of clinicians listed under Optometrist in Rhode Island (2024, 167 clinicians with data). Median for this group: 308. Middle half: 134 to 554.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Billing and prescribing volume is not a quality rating.
-
Medicare Part B services went from 380 in 2020 to 133 in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2020–2024.
Practice Location & Contact Primary Location
166 Cass Ave
Woonsocket, RI 028954712
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
CMS Doctors and Clinicians lists 1 group name: Koch Eye Associates Llp. See the list
Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.
Listings do not confirm current availability, employment or a shared ownership network.
Medicare Profile & Education
Source: CMS Doctors and Clinicians National Downloadable File
Southern College Of Optometry
1987
What Public CMS Data Show
Optometrist: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare patients
76 people with Original Medicare in 2024
It gives a sense of how many people with Medicare this clinician treated that year.
Source: CMS, Medicare Physician & Other Practitioners – by Provider, 2024.
Medicare-allowed amount
About $11,800 in 2024
The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.
Paid by Medicare
About $7,613 in 2024
The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.
30-day fills
141 standardized 30-day fills in 2024
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$4,497 in 2024
The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024.
Open Payments general payments, program year 2025
All general payments: $215.50 across 3 records.
By nature of payment
- Food and Beverage: $215.50 across 3 records.
Reporting-company totals
- Glaukos Corporation: $145.95 across 1 record.
- Sanofi and Genzyme US Companies: $48.08 across 1 record.
- ABBVIE INC.: $21.47 across 1 record.
A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.
Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).
Years since graduation
39 years (graduated 1987)
CMS Doctors and Clinicians data list 1987 as the year this clinician finished professional school.
It tells you roughly how long ago the clinician finished school.
What this does not show: Years since graduation
It is not the number of years in practice, and more years does not mean better care.
Source: CMS Doctors and Clinicians National Downloadable File.
NPI first issued
2006
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Accepts Medicare assignment
CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.
With Original Medicare, you usually pay only your deductible and coinsurance, and the office sends the claim to Medicare for you.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Enrolled in Medicare (PECOS)
Dr. Theroux has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Dr. Theroux as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Woonsocket and Rhode Island
Billing and prescribing volume is not a quality rating.
Medicare Part B services
Fewer Medicare Part B services than 75% of clinicians listed under Optometrist in Rhode Island (2024, 167 clinicians with data). Median for this group: 308. Middle half: 134 to 554.
Too few clinicians listed under Optometrist in Woonsocket have Medicare Part B data for 2024 to compare.
Medicare-allowed amount
A lower Medicare-allowed amount than 75% of clinicians listed under Optometrist in Rhode Island (2024, 167 clinicians with data). Median for this group: $27,297. Middle half: $12,908 to $48,306.
Too few clinicians listed under Optometrist in Woonsocket have Medicare Part B data for 2024 to compare.
Paid by Medicare
A lower Medicare payment amount than 75% of clinicians listed under Optometrist in Rhode Island (2024, 167 clinicians with data). Median for this group: $18,435. Middle half: $8,511 to $32,346.
Too few clinicians listed under Optometrist in Woonsocket have Medicare Part B data for 2024 to compare.
Medicare Part D prescriptions
Fewer Part D prescriptions than 70% of clinicians listed under Optometrist in Rhode Island (2024, 167 clinicians with data). Median for this group: 183. Middle half: 70 to 375.
Too few clinicians listed under Optometrist in Woonsocket have Medicare Part D data for 2024 to compare.
Part D drug cost
A lower Part D drug cost than 65% of clinicians listed under Optometrist in Rhode Island (2024, 167 clinicians with data). Median for this group: $11,802. Middle half: $1,686 to $34,512.
Too few clinicians listed under Optometrist in Woonsocket have Medicare Part D data for 2024 to compare.
12 active clinicians are listed under Optometrist with a practice address in Woonsocket, RI (267 in Rhode Island).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Woonsocket
0% of these 12 clinicians have the CMS telehealth indicator.
75% of these 12 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
-
Medicare Part B services
Medicare Part B services decreased 65% from 380 in 2020 to 133 in 2024.
- 2020: 380
- 2021: 269
- 2022: 86
- 2023: 83
- 2024: 133
-
Medicare-allowed amount
Medicare-allowed amount decreased 70% from $39,680 in 2020 to $11,800 in 2024.
- 2020: $39,680
- 2021: $26,500
- 2022: $9,897
- 2023: $8,412
- 2024: $11,800
-
Paid by Medicare
Paid by Medicare decreased 70% from $25,482 in 2020 to $7,613 in 2024.
- 2020: $25,482
- 2021: $16,337
- 2022: $6,194
- 2023: $4,898
- 2024: $7,613
-
Medicare Part D prescriptions
Medicare Part D prescriptions decreased 73% from 259 in 2020 to 71 in 2024.
- 2020: 259
- 2021: 238
- 2022: 137
- 2023: 70
- 2024: 71
-
30-day fills
30-day fills decreased 68% from 441 in 2020 to 141 in 2024.
- 2020: 441
- 2021: 415
- 2022: 257
- 2023: 122
- 2024: 141
-
Part D drug cost
Part D drug cost decreased 81% from $23,710 in 2020 to $4,497 in 2024.
- 2020: $23,710
- 2021: $17,785
- 2022: $11,293
- 2023: $3,521
- 2024: $4,497
-
Industry payments (Open Payments)
Industry payments (Open Payments) went from $221.37 in 2021 to $215.50 in 2025.
- 2021: $221.37
- 2022: $63.60
- 2023: $457.39
- 2024: $124.68
- 2025: $215.50
Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Pharma & Medical Device Financial Disclosures
Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments
Program year 2025 (payments made January 1 – December 31, 2025): fewer than 11 records totaling $215.50.
| Manufacturer | Payment Nature | Product | Type | Amount ($) |
|---|---|---|---|---|
| Glaukos Corporation |
Food and Beverage
Cash or cash equivalent
|
— | General | $145.95 |
| Sanofi and Genzyme US Companies |
Food and Beverage
In-kind items and services
|
FABRAZYME | General | $48.08 |
| ABBVIE INC. |
Food and Beverage
In-kind items and services
|
LUMIGAN | General | $21.47 |
Source: CMS Open Payments, program year 2025, released June 30, 2026.
Performed Procedures & Service Volume
CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016–2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners – by Provider and Service data, 2017–2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | 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 |
Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2024.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Latanoprost | Latanoprost | 52 | 3,481 | $1,081.85 | 13 |
| Brimonidine Tartrate | Brimonidine Tartrate | 19 | 505 | $3,414.72 | — |
Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2022-09-21NUCC Taxonomy Code: 152W00000X
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
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - OPTOMETRY
I20100612000042
RI
5890825160
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Medicare Group Practice Enrollments
Source: CMS Doctors and Clinicians National Downloadable File
Koch Eye Associates Llp
166 Cass Ave, Woonsocket, RI 028954712
Phone: 4017692511
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Ophthalmology
Doctor of Medicine (M.D.)
Optometrist
Doctor of Optometry
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Registered at 166 CASS AVE UNIT 1, WOONSOCKET, RI 028954712 (Tel: 4017692511)
NPI status registered as active in NPPES database
Registered at 175 PARAMOUNT DR, SUITE 203, RAYNHAM, MA 027671065 (Tel: 7743203040)
Registered at 166 CASS AVE, WOONSOCKET, RI 028954712 (Tel: 4017692511)
Recorded as JAMES THEROUX, O.D.
Optometrist (license number reported to NPPES: RI ODTG00410)
NPI status registered as active in NPPES database
Registered at 166 CASS AVE, WOONSOCKET, RI 028954712 (Tel: 4017692511)
Registered at 566 TOLL GATE RD, WARWICK, RI 028862716 (Tel: 4017384800)
Recorded as JAMES THEROUX, O.D.
Optometrist (license number reported to NPPES: RI ODTG00410)
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Other Optometrists in Woonsocket
- Dr. Vinh Tran, OD
- Dr. Jeffrey Kenyon, OD
- Dr. William Freitas, OD
- Dr. Amanda Paredes, OD
- Dr. Eni Bello, OD
- Nicole Patricio
Mailing Address
166 Cass Ave Unit 1
Woonsocket, RI 028954712
Phone: 4017692511