Individual provider Active NPI

Robert L Ulland, O.D.

  • Optometrist
  • Spokane, WA
National Provider Identifier
1225080070
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3092T Issued in WA
Practice address
9520 N Newport Hwy
Spokane, WA 99218-1219
Phone
(509) 466-6871
Fax
(509) 466-0546
NPI assigned
May 17, 2006
Last updated
Jun 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3092T WA Primary

Addresses

Primary practice location

9520 N Newport Hwy
Spokane, WA 99218-1219

Mailing address

23302 E Desmet CT
Liberty Lake, WA 99019-8539
Phone (509) 979-5324

Other identifiers 1

IdentifierTypeStateIssuer
2005064MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20050812000342 WA Practitioner - Optometry 0345270039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

9326 N Division St
Spokane, WA 99218-1227
Phone (509) 466-7136

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3092TWAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shoptikal LLC Optometrist CurrentSince May 16, 2019 Accepting new patients
Shoptikal LLC Optometrist CurrentSince May 16, 2019 Accepting new patients

Locations

9520 N Newport Hwy
Spokane, WA 99218
Phone (509) 466-6871

9520 N Newport Hwy
#66
Spokane, WA 99218
Phone (509) 466-7136

1340 N Wenatchee Ave
Wenatchee, WA 98801
Phone (509) 663-8868

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1225080070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23302 E DESMET CT",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990198539",
            "telephone_number": "509-979-5324",
            "fax_number": "509-466-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9520 N NEWPORT HWY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181219",
            "telephone_number": "509-466-6871",
            "fax_number": "509-466-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULLAND",
        "first_name": "ROBERT",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3092T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005064",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.