Individual provider Active NPI

Robert Keil Neal, O.D.

  • Optometrist
  • Maple Valley, WA
National Provider Identifier
1376632539
Registry record updated Apr 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003489 Issued in WA
Practice address
26615 Maple Valley Black Diamond Rd SE
Maple Valley, WA 98038-8347
Phone
(425) 413-8787
Fax
(425) 413-4012
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00003489 WA Primary

Addresses

Primary practice location

26615 Maple Valley Black Diamond Rd SE
Maple Valley, WA 98038-8347

Mailing address

26615 Maple Valley Black Diamond Rd SE
Maple Valley, WA 98038-8347
Phone (425) 413-8787

Other identifiers 1

IdentifierTypeStateIssuer
2028967MedicaidWA

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
I20040507000115 WA Practitioner - Optometry 4587653563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Maple Valley Eye Care Center PSGroup PAC ID 0446249411, 5 clinicians

Practice addresses (Care Compare)

26615 Maple Valley Black Diamond Rd
Maple Valley, WA 98038-8347
Phone (425) 413-8787

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Benson Vision Source, Inc. Optometrist CurrentSince Nov 23, 2019 Accepting new patients
Eye Doctors LTD PS Optometrist Past Accepting new patients

Locations

25022 104th Ave SE
Ste D
Kent, WA 98030
Phone (253) 859-1911

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745712000000",
    "number": "1376632539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26615 MAPLE VALLEY BLACK DIAMOND RD SE",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980388347",
            "telephone_number": "425-413-8787",
            "fax_number": "425-413-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26615 MAPLE VALLEY BLACK DIAMOND RD SE",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980388347",
            "telephone_number": "425-413-8787",
            "fax_number": "425-413-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "ROBERT",
        "middle_name": "KEIL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-04-27",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2028967",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Valley, WA

Sources for this page

Verify at the official NPI Registry.