NPIMap

Organization Active NPI

Robert L. Miller, OD Inc.

  • Optometrist
  • Hartville, OH
National Provider Identifier
1225040868
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4371 Issued in OH
Legal business name
ROBERT L. MILLER, OD INC.
Practice address
500 S Prospect Ave
Hartville, OH 44632-9403
Phone
(330) 877-2117
Fax
(330) 877-1617
NPI assigned
Aug 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Robert L Miller, ODNPI 1073682076
Title
Owner
Phone
(330) 877-2117

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4371 OH Primary

Addresses

Primary practice location

500 S Prospect Ave
Hartville, OH 44632-9403

Mailing address

500 S Prospect Ave
Hartville, OH 44632-9403
Phone (330) 877-2117

Other identifiers 1

IdentifierTypeStateIssuer
0111739MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070108000437 OH Part B Supplier - Clinic/Group Practice 5597765925 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Berlin, OH; Hartville, OH
O20100930029481 OH DME Supplier - Physician - Optometrist 5597765925 Practice locations: Hartville, OH

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Family Eye Care500 S Prospect Ave, Hartville, OH 44632-8401(330) 877-2117 Prosthetic Lenses: Conventional Eyeglasses Accepts assignmentParticipating since Nov 22, 2006

National Provider Directory

National Provider Directory
Tax ID family
Robert L Miller OD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225040868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S PROSPECT AVE",
            "city": "HARTVILLE",
            "state": "OH",
            "postal_code": "446329403",
            "telephone_number": "330-877-2117",
            "fax_number": "330-877-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S PROSPECT AVE",
            "city": "HARTVILLE",
            "state": "OH",
            "postal_code": "446329403",
            "telephone_number": "330-877-2117",
            "fax_number": "330-877-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT L. MILLER, OD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-877-2117",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0111739",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.