Individual provider Active NPI

Robert P Chelberg, O.D.

  • Optometrist
  • Keshena, WI
National Provider Identifier
1225033137
Registry record updated Jul 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2847-035 Issued in WI
Practice address
W3275 Wolf River Road
Keshena, WI 54135
Phone
(715) 799-5482
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2847-035 WI Primary
Optometrist 152W00000X 046-009613 IL

Addresses

Primary practice location

W3275 Wolf River Road
Keshena, WI 54135

Mailing address

PO Box 970
Keshena, WI 54135-0970
Phone (715) 799-5803

Other identifiers 1

IdentifierTypeStateIssuer
38613800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20040701001024 WI Practitioner - Optometry 6507843125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

W3275 Wolf River Dr
Keshena, WI 54135-9202
Phone (715) 799-3361

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-009613ILMDOptometrist
2847-035WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Menominee Indian Tribe of Wisconsin CurrentSince Jan 14, 2005 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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499385600000",
    "number": "1225033137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "KESHENA",
            "state": "WI",
            "postal_code": "541350970",
            "telephone_number": "715-799-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3275 WOLF RIVER ROAD",
            "city": "KESHENA",
            "state": "WI",
            "postal_code": "54135",
            "telephone_number": "715-799-5482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHELBERG",
        "first_name": "ROBERT",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2017-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2847-035",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009613",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38613800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keshena, WI

Sources for this page

Verify at the official NPI Registry.