Individual provider Active NPI

Robert F. Koerner, O.D.

  • Optometrist
  • Columbus, OH
National Provider Identifier
1184605180
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4363 Issued in OH
Practice address
553 E Town St
Columbus, OH 43215-4856
Phone
(614) 461-1885
Fax
(614) 461-5730
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 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 4363 OH Primary

Addresses

Primary practice location

553 E Town St
Columbus, OH 43215-4856

Mailing address

553 E Town St
Columbus, OH 43215-4856
Phone (614) 461-1885

Other identifiers 1

IdentifierTypeStateIssuer
0995151MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20050405000053 OH Practitioner - Optometry 4688621402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarkson Optometry Midwest IncGroup PAC ID 0749504165, 78 clinicians

Practice addresses (Care Compare)

1650 S Union Ave
Alliance, OH 44601-4349
Phone (330) 821-2020

553 E Town St
Columbus, OH 43215-4927
Phone (614) 461-1885

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4363OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkson Optometry Midwest Inc Optometrist CurrentSince Mar 3, 2020 Accepting new patients
20-20 Eyecare PSC Optometrist Past Accepting new patients

Locations

1650 S Union Ave
Alliance, OH 44601
Phone (330) 630-9699

Interoperability endpoints

  • Direct secure messaging: robertkoerner@direct.eyecare-partners.com

Organizations & group practices 3

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1184605180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 E TOWN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154856",
            "telephone_number": "614-461-1885",
            "fax_number": "614-461-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 E TOWN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154856",
            "telephone_number": "614-461-1885",
            "fax_number": "614-461-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOERNER",
        "first_name": "ROBERT",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0995151",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.