Individual provider Active NPI

Robert John Cavaliere Jr.

  • Podiatrist
  • Shelton, WA
National Provider Identifier
1366947434
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO61160944 Issued in WA
Practice address
1701 N 13TH St
Shelton, WA 98584-2077
Phone
(360) 426-2653
NPI assigned
Mar 29, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X PO61160944 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1701 N 13TH St
Shelton, WA 98584-2077

Mailing address

PO Box 1668
Shelton, WA 98584-5001
Phone (360) 427-9549

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20210630001746 WA Practitioner - Podiatry 6103227954 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital District No 1 of Mason CountyGroup PAC ID 0345139275, 60 clinicians

Practice addresses (Care Compare)

1701 N 13TH St
Shelton, WA 98584-2077
Phone (360) 426-2653

Hospital & facility affiliations

  • Mason General Hospital & Family of Clinics Hospital, Shelton, WA, CCN 501336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO61160944WAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 1 of Mason County Multi-Specialty CurrentSince Jul 12, 2021 Accepting new patients
Public Hospital District No 1 of Mason County Wa Multi-Specialty CurrentSince Jul 12, 2021 Accepting new patients
Public Hospital District No 1 of Mason County Multi-Specialty CurrentSince Jan 27, 2026 Accepting new patients

Locations

1701 N 13th St
Shelton, WA 98584
Phone (360) 426-2653

901 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-1611

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1366947434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1668",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985845001",
            "telephone_number": "360-427-9549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N 13TH ST",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842077",
            "telephone_number": "360-426-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVALIERE",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO61160944",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, WA

Sources for this page

Verify at the official NPI Registry.