Individual provider Active NPI

Robert Edward Bromm, O.D.

  • Optometrist
  • Evansville, IN
National Provider Identifier
1083641633
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18001664A Issued in IN
Practice address
1150 Lincoln Ave
Evansville, IN 47714-1071
Phone
(812) 477-3937
NPI assigned
Jun 27, 2006
Last updated
Jul 31, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18001664A IN Primary

Addresses

Primary practice location

1150 Lincoln Ave
Evansville, IN 47714-1071

Mailing address

10144 Byron CT
Newburgh, IN 47630-9350
Phone (812) 490-0967

Other identifiers 2

IdentifierTypeStateIssuer
18001664AOtherININDIANA LICENSE
18001664BOtherINOLDPAC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18001664AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
American Eye Associates, LLC Past Accepting new patients
Hayden Vision LLC Optometrist Past Accepting new patients

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1083641633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10144 BYRON CT",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309350",
            "telephone_number": "812-490-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 LINCOLN AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477141071",
            "telephone_number": "812-477-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMM",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001664A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE",
            "identifier": "18001664A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLDPAC",
            "identifier": "18001664B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.