Individual provider Active NPI

Robert Kreuter, O.D.

  • Optometrist
  • Lancaster, OH
National Provider Identifier
1154316461
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4210 Issued in OH
Practice address
1222 N Memorial Dr
Lancaster, OH 43130-1625
Phone
(740) 687-1502
Fax
(740) 687-4723
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4210 OH Primary

Addresses

Primary practice location

1222 N Memorial Dr
Lancaster, OH 43130-1625

Mailing address

1222 N Memorial Dr
Lancaster, OH 43130-1625
Phone (740) 687-1502

Other identifiers 1

IdentifierTypeStateIssuer
0798909MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100325000580 OH Practitioner - Optometry 9537295829 Practice locations: Lancaster, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4210OHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hughes Quality Eyecare, LLC Optometrist PastSince Nov 1, 2019 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1154316461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 N MEMORIAL DR",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431301625",
            "telephone_number": "740-687-1502",
            "fax_number": "740-687-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 N MEMORIAL DR",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431301625",
            "telephone_number": "740-687-1502",
            "fax_number": "740-687-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREUTER",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0798909",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.