Individual provider Active NPI

Robert Roden, OD

  • Optometrist
  • Amarillo, TX
National Provider Identifier
1407337280
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10917762-9934 Issued in UT
Practice address
6010 W Amarillo Blvd
Amarillo, TX 79106-1990
Phone
(806) 355-9703
NPI assigned
Aug 28, 2018
Last updated
Aug 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10917762-9934 UT Primary

Addresses

Primary practice location

6010 W Amarillo Blvd
Amarillo, TX 79106-1990

Mailing address

6010 W Amarillo Blvd
Amarillo, TX 79106-1990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20190621001679 UT Practitioner - Optometry 7416281621 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10917762-9934UTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain University of Health Professions Foundation Optometrist CurrentSince Jun 1, 2024 Accepting new patients
Standard Optical Co Optometrist Current Accepting new patients
Standard Optical Company Optometrist CurrentSince Jul 1, 2019 Accepting new patients
Standard Optical Co Optometrist CurrentSince Jul 1, 2019 Accepting new patients
Reese and Weaver, Ods LLC Optometrist CurrentSince Jul 1, 2019 Accepting new patients
Standard Optical Co Optometrist Past Accepting new patients
Standard Optical Co Optometrist Past Accepting new patients

Locations

3435 N Center St
#1
Lehi, UT 84043
Phone (801) 756-7150

5289 S State St
Murray, UT 84107
Phone (801) 506-1111

122 E 1700 S
Bldg 3
Provo, UT 84606
Phone (385) 248-5550

834 E 9400 S
Sandy, UT 84094
Phone (801) 553-9330

1528 N Commerce Dr
Ste 102
Saratoga Springs, UT 84045
Phone (801) 768-1900

3754 W 5400 S
Taylorsville, UT 84129
Phone (801) 964-9911

966 N Main St
Tooele, UT 84074
Phone (435) 882-4815

1656 W 9000 S
West Jordan, UT 84088
Phone (801) 255-5454

1901 W Parkway Blvd
West Valley City, UT 84119
Phone (801) 886-2020

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1407337280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 W AMARILLO BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 W AMARILLO BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061990",
            "telephone_number": "806-355-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEN",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "10917762-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.