Individual provider Active NPI

Robert M Paluska, O.D.

  • Optometrist
  • Salem, OR
National Provider Identifier
1043345275
Registry record updated Dec 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3097ATI Issued in OR
Practice address
1309 Liberty St SE
Salem, OR 97302-4245
Phone
(503) 585-2022
Fax
(503) 378-0797
NPI assigned
Feb 21, 2007
Last updated
Dec 17, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3097ATI OR Primary

Addresses

Primary practice location

1309 Liberty St SE
Salem, OR 97302-4245

Mailing address

1309 Liberty St SE
Salem, OR 97302-4245
Phone (503) 585-2022

Other identifiers 1

IdentifierTypeStateIssuer
165456MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20101007001196 OR Practitioner - Optometry 4981813474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1994
Medicare assignment
May accept Medicare assignment
Group practices
Eye Care Physicians and Surgeons IncGroup PAC ID 6103812557, 11 clinicians

Practice addresses (Care Compare)

1309 Liberty St SE
Salem, OR 97302-4245
Phone (503) 585-2022

Merit-based Incentive Payment System (MIPS)

Final score
89.75 of 100Reported as group
Quality
89.59
Improvement activities
40
Cost
79.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3097ATIORMDOptometrist
3097ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Physicians & Surgeons, Inc. CurrentSince Jun 1, 1994 Accepting new patients
Eye Care Physicians & Surgeons, Inc. PastSince Jun 1, 1994 Accepting new patients

Locations

5750 Inland Shores Way N
Keizer, OR 97303
Phone (503) 585-2022

1309 Liberty St SE
Salem, OR 97302
Phone (503) 585-2022

2001 Commercial St SE
Salem, OR 97302
Phone (503) 363-1500

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: robert.paluska.p1@direct.eyecarephysicians.nextgenshare.com

Organizations & group practices 2

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1043345275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024245",
            "telephone_number": "503-585-2022",
            "fax_number": "503-378-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024245",
            "telephone_number": "503-585-2022",
            "fax_number": "503-378-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALUSKA",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3097ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165456",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.