Robert Bailen, ABO

Primary specialty

OpticianTaxonomy code 156FX1800X

Practice address

207 2ND Ave W
Ashland, WI 54806-1605

Phone

(715) 682-8181

Fax

(715) 682-8181

NPI assigned

Nov 26, 2018

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1326518002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 9TH AVE W",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548062810",
            "telephone_number": "715-209-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 2ND AVE W",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548061605",
            "telephone_number": "715-682-8181",
            "fax_number": "715-682-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEN",
        "first_name": "ROBERT",
        "credential": "ABO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Ashland, WI
• Optician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.