Chad Roberts, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

289T Issued in WY

Practice address

110 Buffalo Way
Ste a
Jackson, WY 83002

Phone

(307) 733-4905

Fax

(307) 733-4906

NPI assigned

Feb 28, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Grand Teton Eye & Optical

  • Optometrist
  • Jackson, WY
  • NPI 1306983655
  Medicare reassignment Authorized official
• Wyoming Eye Care Inc PC

  • Optometrist
  • Jackson, WY
  • NPI 1972645315
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295863504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8460",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830028460",
            "telephone_number": "307-733-4905",
            "fax_number": "307-733-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BUFFALO WAY",
            "address_2": "STE A",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83002",
            "telephone_number": "307-733-4905",
            "fax_number": "307-733-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CHAD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "289T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Guillermo Rivas, PPC
• Emily Rivera Garcia
• RJ Smiles, LLC
• Roadrunner Apothecary, LLC
• Robert J Brock MD PC
• Mary Maureen Roberts
• Shannon Christine Roberts, MD FACOG
• Lisa G Robertson, OT
• Michelle Robertson
• Chelsea Robin

• Optometrist in Jackson, WY
• Providers in Jackson, WY by specialty
• Optometrist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.