Individual provider Active NPI

Frank Robinson Jr., O.D.

  • Optometrist
  • Fort Wayne, IN
National Provider Identifier
1043223423
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002274 Issued in IN
Practice address
6710 Old Trail Rd
Fort Wayne, IN 46809-2639
Phone
(260) 203-5905
Fax
(260) 218-1802
NPI assigned
Aug 15, 2006
Last updated
Apr 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002274 IN Primary

Addresses

Primary practice location

6710 Old Trail Rd
Fort Wayne, IN 46809-2639

Mailing address

6710 Old Trail Rd
Fort Wayne, IN 46809-2639
Phone (260) 203-5905

Other identifiers 1

IdentifierTypeStateIssuer
100257880 HMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20080128000166 IN Practitioner - Optometry 7113009325 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18002274INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Vision, LLC Optometrist Current Accepting new patients
Wisconsin Vision, LLC Optometrist CurrentSince Apr 1, 2022 Accepting new patients
Wisconsin Vision, Inc Optometrist CurrentSince Apr 1, 2022 Accepting new patients

Locations

3972 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-1998

16800 W Cleveland Ave
New Berlin, WI 53151
Phone (262) 432-2005

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1043223423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6710 OLD TRAIL RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468092639",
            "telephone_number": "260-203-5905",
            "fax_number": "260-218-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6710 OLD TRAIL RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468092639",
            "telephone_number": "260-203-5905",
            "fax_number": "260-218-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "FRANK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100257880 H",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.