Robert Emmett Deck III, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003566 Issued in MI

Practice address

81 Indianwood Rd
Suite 1
Lake Orion, MI 48362-1595

Phone

(248) 693-2321

NPI assigned

Jul 18, 2006

Last updated

Dec 10, 2009By the provider in NPPES

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 MI

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)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Robert E Deck III, O.D., PLLC

  • Optometrist
  • Burton, MI
  • NPI 1720779275
  NPD Authorized official
• Heritage Optical Center Inc

  • Optometrist
  • Detroit, MI
  • NPI 1285728964
  Medicare reassignment
• Heritage Optical Center

  • Optometrist
  • Detroit, MI
  • NPI 1689905929
  NPD (past)
• Heritage Optical Inc.

  • Optometrist
  • Detroit, MI
  • NPI 1053642397
  NPD (past)
• Lake Orion Vision PC

  • Optometrist
  • Lake Orion, MI
  • NPI 1881072494
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260403200000",
    "number": "1437177342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 INDIANWOOD RD",
            "address_2": "SUITE 1",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483621595",
            "telephone_number": "248-693-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 INDIANWOOD RD",
            "address_2": "SUITE 1",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483621595",
            "telephone_number": "248-693-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECK",
        "first_name": "ROBERT",
        "middle_name": "EMMETT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2009-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324-0332",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsie Marie Davis, DPT
• Krystal Laura Dayton, MSW,CSW
• Kennedy Riley Dean
• Brett Debo, MPT
• Deborah Dehaan, D.D.S., M.S., P.C.
• Sarah Degnan, CPNP, CNM
• Dehaan Othodontics
• David Andrew Dehaan, D.D.S., M.S.
• Deborah Dehaan, D.D.S., M.S., P.C.
• Kirk Allen Deherder, FNP-BC

• Optometrist in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.