Robert Ken Matoba, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT1378 Issued in CO

Practice address

200 Union Blvd
Suite 415
Lakewood, CO 80228-1830

Phone

(303) 988-2777

Fax

(303) 988-8855

NPI assigned

Dec 1, 2005

Last updated

Mar 27, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Optometry

Education

Southern California College of Optometry, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DRS Matoba Optometrists LLCGroup PAC ID 6507148517, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• DRS Matoba Optometrists LLC

  • Optometrist
  • Lakewood, CO
  • NPI 1518400571
  Medicare reassignment Care Compare group NPD
• Esther Naomi Matoba, O.D.

  • Optometrist
  • Lakewood, CO
  • NPI 1558345751
  Medicare reassignment

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1215911417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 UNION BLVD",
            "address_2": "SUITE 415",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281830",
            "telephone_number": "303-988-2777",
            "fax_number": "303-988-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UNION BLVD",
            "address_2": "SUITE 415",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281830",
            "telephone_number": "303-988-2777",
            "fax_number": "303-988-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOBA",
        "first_name": "ROBERT",
        "middle_name": "KEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT1378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79637256",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CO303184",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Ann Matoba, OD
• Esther Naomi Matoba, O.D.
• Glenn T Matoba, OD
• Joel Matoba, O.D.
• Kirk Matoba, OD
• Mats Medical Supply LLC.
• Kevin Alexander Matson
• Thomas Kenneth Matsui, DDS
• Matt Trowbridge Counseling
• Alissa Matze

• Optometrist in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.