Individual provider Active NPI

Michael A. Robin, O.D.

  • Optometrist
  • Ellicott City, MD
National Provider Identifier
1447396700
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA 0893 Issued in MD
Practice address
10176 Baltimore National Pike
Suite 113
Ellicott City, MD 21042
Phone
(410) 461-7012
Fax
(410) 461-7009
NPI assigned
Jan 30, 2007
Last updated
Feb 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 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 TA 0893 MD Primary

Addresses

Primary practice location

10176 Baltimore National Pike
Suite 113
Ellicott City, MD 21042

Mailing address

10176 Baltimore National Pike
Suite 113
Ellicott City, MD 21042
Phone (410) 461-7012

Other identifiers 3

IdentifierTypeStateIssuer
755OtherBALTIMORE CITY VISION CAR
209QOtherMEDICARE
111333OtherEYEMED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060508000266 DC Practitioner - Optometry 9032120977
I20081002000054 MD Practitioner - Optometry 9032120977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

916 Washington Ave
PO Box 612
Chestertown, MD 21620-0612
Phone (410) 778-0094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA 0893MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dependable Eye Care Inc Optometrist CurrentSince Mar 13, 2008 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mrobin@462.securemail.prognocis.com

Organizations & group practices 2

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1447396700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10176 BALTIMORE NATIONAL PIKE",
            "address_2": "SUITE 113",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21042",
            "telephone_number": "410-461-7012",
            "fax_number": "410-461-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10176 BALTIMORE NATIONAL PIKE",
            "address_2": "SUITE 113",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21042",
            "telephone_number": "410-461-7012",
            "fax_number": "410-461-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBIN",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA 0893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BALTIMORE CITY VISION CAR",
            "identifier": "755",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "209Q",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "111333",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.