Roger Munk, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3080ATI Issued in OR

Practice address

90 Market St
Ste 20
Lebanon, OR 97355-2396

Phone

(541) 451-1144

Fax

(541) 451-1785

NPI assigned

May 24, 2005

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

Other identifiers 1

Other names 1

• Roger Munk Former name

Medicare fee-for-service enrollment

Enrolled in OR

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, 1994

Medicare assignment

May accept Medicare assignment

Group practices

Lifetime Vision Source of Lebanon LLCGroup PAC ID 6608773148, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lifetime Vision Source of Lebanon LLC

  • Optometrist
  • Lebanon, OR
  • NPI 1710168877
  Medicare reassignment Care Compare group NPD
• Eyecare Associates PC

  • Ophthalmology Physician
  • Albany, OR
  • NPI 1013964113

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1316940281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MARKET ST",
            "address_2": "STE 20",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973552396",
            "telephone_number": "541-451-1144",
            "fax_number": "541-451-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 MARKET ST",
            "address_2": "STE 20",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973552396",
            "telephone_number": "541-451-1144",
            "fax_number": "541-451-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNK",
        "first_name": "ROGER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3080ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128772",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROGER",
            "last_name": "MUNK",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carolyn Mae Moore, L.C.S.W.
• Timothy Evan Moore
• Edward Charles Morell, RN
• Craig G. Morton, DMD
• Jalina Mueller
• Erin Murashige
• Laine J Murphey, MD
• Nathan a Tolman, DMD, PC
• Xiaosong Wang Natterer, DDS
• Aria Naziri

• Optometrist in Lebanon, OR
• Providers in Lebanon, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.