Individual provider Active NPI

Brian W Roberts, O.D.

  • Optometrist
  • Calera, AL
National Provider Identifier
1245299866
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S991-TA563 Issued in AL
Practice address
5100 Highway 31
Calera, AL 35040-5154
Phone
(205) 668-2633
Fax
(205) 668-4269
NPI assigned
Mar 22, 2006
Last updated
Oct 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S991-TA563 AL Primary

Addresses

Primary practice location

5100 Highway 31
Calera, AL 35040-5154

Mailing address

5100 Highway 31
Calera, AL 35040-5154
Phone (205) 668-2633

Other identifiers 1

IdentifierTypeStateIssuer
02-0691178OtherALTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20111122000741 AL Practitioner - Optometry 2668646910 Reassigns benefits to 1 organization
Practice locations: Calera, AL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Alabama School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
360Care Services of Al LLCGroup PAC ID 7719240977, 29 clinicians

Practice addresses (Care Compare)

150 S Perry St
Montgomery, AL 36104-4227
Phone (248) 528-2116

5100 Hwy 31
Calera, AL 35040

5100 Hwy 31
Calera, AL 35040-5154
Phone (205) 668-2633

Merit-based Incentive Payment System (MIPS)

Final score
75.77 of 100Reported as group
Quality
45.94
Promoting interoperability
85
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
360Care Services of Al LLC Optometrist CurrentSince Aug 4, 2022 Accepting new patients

Locations

150 S Perry St
Montgomery, AL 36104
Phone (225) 270-1012

523 Gandy St NE
Ste A
Russellville, AL 35653
Phone (205) 208-9955

11 Bell Rd
Selma, AL 36701
Phone (334) 874-7425

4350 Brownsboro Rd
Ste 210
Louisville, KY 40207
Phone (830) 212-1661

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, 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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1245299866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 HIGHWAY 31",
            "city": "CALERA",
            "state": "AL",
            "postal_code": "350405154",
            "telephone_number": "205-668-2633",
            "fax_number": "205-668-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 HIGHWAY 31",
            "city": "CALERA",
            "state": "AL",
            "postal_code": "350405154",
            "telephone_number": "205-668-2633",
            "fax_number": "205-668-4269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BRIAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S991-TA563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "02-0691178",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calera, AL

Sources for this page

Verify at the official NPI Registry.