Robert Leif Erickson, O.D.
Individual provider Active NPI Optometrist · Rutland, VT
NPI 1285673095 · NPPES record last updated Nov 19, 2007
Key facts
- NPI
- 1285673095
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 030-0000275 (VT)
- Practice address
- 44 Washington St
Rutland, VT 05701-5031 - Phone
- (802) 775-0862
- Fax
- (802) 747-7714
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- New England College of Optometry, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
306 Depot St
Manchester Center, VT 05255-9703
Phone (802) 362-2020
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060713000038 | VT | Practitioner - Optometry | 5294748315 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manchester Eye Care PC | Current |
Accepting new patients |
Locations
306 Depot St
Manchester Center, VT 05255
Phone (802) 362-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 030-0000275 | VT | Yes |
Addresses
Primary practice location
44 Washington St
Rutland, VT 05701-5031
Mailing address
PO Box 311
Weston, VT 05161-0311
Phone (802) 824-3695
Other providers in Rutland, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.