Active NPI
Robert William Seidel, OD
- Optometrist
- Fremont, MI
National Provider Identifier
1457456709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901003237
- Practice address
- 7083 West 48TH St
Fremont, MI 49412 - Phone
- (231) 924-9507
- Fax
- (231) 924-9548
- NPI assigned
- Sep 13, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901003237 | MI | Primary |
Addresses
Primary practice location
7083 West 48TH St
Fremont, MI 49412
Mailing address
1495 Marilyn Ave
Ludington, MI 04102
Phone (231) 843-1562
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kent Vision Centers Inc | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457456709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1495 MARILYN AVE",
"city": "LUDINGTON",
"state": "MI",
"postal_code": "04102",
"telephone_number": "231-843-1562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7083 WEST 48TH ST",
"city": "FREMONT",
"state": "MI",
"postal_code": "49412",
"telephone_number": "231-924-9507",
"fax_number": "231-924-9548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEIDEL",
"first_name": "ROBERT",
"middle_name": "WILLIAM",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901003237",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.