Individual provider Active NPI

Robert William Moses, O.D.

  • Optometrist
  • Merrillville, IN
National Provider Identifier
1417938010
Registry record updated Jun 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18001579 Issued in IN
Practice address
70 E 68TH PL
Merrillville, IN 46410-3506
Phone
(219) 736-2020
Fax
(219) 769-3884
NPI assigned
Nov 10, 2005
Last updated
Jun 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18001579 IN Primary

Addresses

Primary practice location

70 E 68TH PL
Merrillville, IN 46410-3506

Mailing address

70 E 68TH PL
Merrillville, IN 46410-3506
Phone (219) 736-2020

Other identifiers 5

IdentifierTypeStateIssuer
410041743OtherINRAILROAD MEDICARE
100362050MedicaidIN
410016959OtherINRAILROAD MEDICARE
580001141OtherINRAILROAD MEDICARE
410040620OtherINRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20061011000582 IN Practitioner - Optometry 5395725469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

70 E 68TH PL
Merrillville, IN 46410-3506
Phone (219) 769-2606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18001579INMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert W Moses O.D. Professional Corporation Optometrist CurrentSince Jul 11, 1972 Accepting new patients
Robert W Moses OD Professional Corp. Optometrist Past Accepting new patients

Locations

10707 Randolph St
Crown Point, IN 46307
Phone (219) 226-9477

1861 E Summit St
Crown Point, IN 46307
Phone (219) 617-5058

3229 Broadway
Ste 205
Gary, IN 46409
Phone (219) 806-3000

701 W 5th Ave
Gary, IN 46402
Phone (219) 881-0655

130 S Broad St
Griffith, IN 46319
Phone (219) 924-8000

7414 Indianapolis Blvd
Hammond, IN 46324
Phone (219) 736-2020

615 N Main St
Hebron, IN 46341
Phone (219) 996-2800

630 N Front St
Hebron, IN 46341
Phone (219) 995-2800

117 Deanna Dr
Lowell, IN 46356
Phone (219) 696-8077

70 E 68th Pl
Merrillville, IN 46410
Phone (219) 736-2020

7974 Wicker Ave
Saint John, IN 46373
Phone (833) 376-6737

Organizations & group practices 5

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306972800000",
    "number": "1417938010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 E 68TH PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464103506",
            "telephone_number": "219-736-2020",
            "fax_number": "219-769-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 E 68TH PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464103506",
            "telephone_number": "219-736-2020",
            "fax_number": "219-769-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "ROBERT",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2011-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410041743",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100362050",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410016959",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "580001141",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410040620",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

Verify at the official NPI Registry.