Robert Edward Stauble III, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG003334 Issued in PA

Practice address

524 S 2ND St
Philadelphia, PA 19147-2409

Phone

(215) 372-0147

Fax

(215) 372-0157

NPI assigned

Aug 8, 2017

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

Medicare fee-for-service enrollment

Enrolled in PA

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

Pennsylvania College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Stauble Eye Care LLC

  • Optometrist
  • Philadelphia, PA
  • NPI 1154926376
  Medicare reassignment NPD Authorized official
• America'S Best Contacts & Eyeglasses

  • Eyewear Supplier
  • Springfield, PA
  • NPI 1427089093
  NPD (past)

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1417472614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 S 2ND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191472409",
            "telephone_number": "215-372-0147",
            "fax_number": "215-372-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 S 2ND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191472409",
            "telephone_number": "215-372-0147",
            "fax_number": "215-372-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUBLE",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-08",
        "last_updated": "2024-03-15",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Statewide Community Counseling Services Inc
• Shelby Statham
• Megan Grace Stathes, CRNA
• Statum Health
• Stauble Eye Care LLC
• Alexis Noel Staudenmeier, AUD
• Kathryne Staudinger, MD
• Ashley Stauffer, DPT
• Colleen Marie Stauffer, RD, LDN
• Tatum Stauffer, DO

• Optometrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.