Jerry D Roberts, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

T02783 Issued in MO

Practice address

507 E Cleveland Ave
Monett, MO 65708-1750

Phone

(417) 235-5250

Fax

(417) 235-5250

NPI assigned

Jan 27, 2006

Last updated

Jun 30, 2010By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in MO

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

University of Missouri St Louis - School of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nestleroad and Roberts, OptometristsGroup PAC ID 3274658018, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
• IA HMO C-SNP
• IA HMO

Interoperability endpoints

• Direct secure messaging: jerry.roberts@direct.revolutionehr.com

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

• Roberts Family Eyecare

  • Optometrist
  • Monett, MO
  • NPI 1215028097
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1033180336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 E CLEVELAND AVE",
            "address_2": "PO BOX 351",
            "city": "MONETT",
            "state": "MO",
            "postal_code": "657081750",
            "telephone_number": "417-235-5250",
            "fax_number": "417-235-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 E CLEVELAND AVE",
            "city": "MONETT",
            "state": "MO",
            "postal_code": "657081750",
            "telephone_number": "417-235-5250",
            "fax_number": "417-235-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JERRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "312562606",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regional Services (Sergio Cruz, Jr. M.D.)
• Regional Services (Steven E. Newbold, M.D.)
• Regional Services (Family Practice and Obstetrics of Monett)
• Roberts Family Eyecare
• Aubrey Roberts, OD
• Michael Jay Roberts, OD
• RPCS, Inc (Price Cutter Pharmacy #5)
• Tomas Anders, Johan Saaf
• Timothy Salar, DMD
• Beatriz Sanchez

• Optometrist in Monett, MO
• Providers in Monett, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.