Robert David Peek, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1719AT Issued in OR

Practice address

5045 SW 77TH Ave
Portland, OR 97225-1812

Phone

(503) 297-1096

Fax

(503) 296-7240

NPI assigned

Oct 24, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• All Family Vision LLC

  • Optometrist
  • Corvallis, OR
  • NPI 1255600763
  NPD (past)
• Hawthorne Vision Center PC

  • Optometrist
  • Portland, OR
  • NPI 1770699860
  NPD (past)

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1437149390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 OAKRIDGE RD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970353312",
            "telephone_number": "503-635-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5045 SW 77TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251812",
            "telephone_number": "503-297-1096",
            "fax_number": "503-296-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEEK",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1719AT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194712",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rodrigo Pedraza Rosales, M.D.
• Maricela Pedro
• Winnie Pedro, RPH
• Benjamin Pedroja, MD
• Mariah F Peebles, MSW
• David Harris Peel, M.D.
• Katrina Dalrymple Peel, RN
• Kelly Christine Peel, PHARMD
• Lynda R Peel, MD
• Kelly Peeler

• Optometrist in Portland, OR
• Providers in Portland, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.