Individual provider Active NPI

Rodney Lee Robertson, OD

  • Optometrist
  • Mesquite, TX
National Provider Identifier
1437138484
Registry record updated Oct 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3735TG Issued in TX
Practice address
1220 N Town East Blvd
Suite 220
Mesquite, TX 75150-7605
Phone
(972) 613-9000
Fax
(972) 613-0175
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3735TG TX Primary

Addresses

Primary practice location

1220 N Town East Blvd
Suite 220
Mesquite, TX 75150-7605

Mailing address

1220 N Town East Blvd
Suite 220
Mesquite, TX 75150-7605
Phone (972) 613-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120927000802 TX Practitioner - Optometry 9335398700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JW Eye Associates, PLLCGroup PAC ID 6305828567, 35 clinicians

Practice addresses (Care Compare)

11442 N Central Expy
Dallas, TX 75243-6602

1220 N Town E Blvd
Suite 220 Key Whitman Eye Center
Mesquite, TX 75150-4682
Phone (214) 754-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3735TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
JW Eye Associates, PLLC Optometrist Current Accepting new patients
JW Eye Associates, PLLC Optometrist CurrentSince Oct 1, 2023 Accepting new patients
JW Eye Associates, PLLC Optometrist CurrentSince Oct 1, 2023 Accepting new patients

Locations

11442 N Central Expy
Dallas, TX 75243
Phone (214) 220-3937

1220 N Town East Blvd
Ste 220
Mesquite, TX 75150
Phone (972) 613-9000

Interoperability endpoints

  • Direct secure messaging: rrobertson@kwec.intellechartdirect.net

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381708800000",
    "number": "1437138484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 N TOWN EAST BLVD",
            "address_2": "SUITE 220",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751507605",
            "telephone_number": "972-613-9000",
            "fax_number": "972-613-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 N TOWN EAST BLVD",
            "address_2": "SUITE 220",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751507605",
            "telephone_number": "972-613-9000",
            "fax_number": "972-613-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "RODNEY",
        "middle_name": "LEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2013-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3735TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.