Active NPI
Robert Dewey Blase, OD
- Optometrist
- Wyoming, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG000804
- Practice address
- 155 Wyoming Ave
Wyoming, PA 18644-1708 - Phone
- (570) 693-1578
- Fax
- (570) 693-2010
- NPI assigned
- Mar 23, 2006
- 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 | OEG000804 | PA | Primary |
Addresses
Primary practice location
155 Wyoming Ave
Wyoming, PA 18644-1708
Mailing address
703 Rutter Ave
Kingston, PA 18704-4801
Phone (570) 288-7405
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000901188 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
170 Boston Ave
West Pittston, PA 18643-2724
Phone (570) 602-1010
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.08 of 100
- Quality
- 85.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 64.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OEG000804 | PA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Innovation Centers of PA LLC | Optometrist | Current | Accepting new patients |
| Vision Innovation Centers of Pennsylvania LLC | Optometrist | Current | Accepting new patients |
| Vision Innovation Centers of Pennsylvania LLC | Optometrist | Current | Accepting new patients |
| Vision Innovation Centers of Pennsylvania LLC | Optometrist | Past | Accepting new patients |
Locations
2661 Riva Rd
Ste 1030
Annapolis, MD 21401
40 Dallas Village Shopping Ctr
Dallas, PA 18612
Phone (570) 674-9001
703 Rutter Ave
Kingston, PA 18704
Phone (570) 288-7405
170 Boston Ave
West Pittston, PA 18643
Phone (570) 602-1010
Interoperability endpoints
- rblase@vip.emadirect.md
Organizations & group practices 4
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.
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- NPI 1962046458
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- Durable Medical Equipment & Medical Supplies
- Berwick, PA
- NPI 1831733260
Optometrist
-
- Durable Medical Equipment & Medical Supplies
- Nanticoke, PA
- NPI 1104460542
Optometrist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392940800000",
"number": "1477513612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 RUTTER AVE",
"city": "KINGSTON",
"state": "PA",
"postal_code": "187044801",
"telephone_number": "570-288-7405",
"fax_number": "570-288-7406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 WYOMING AVE",
"city": "WYOMING",
"state": "PA",
"postal_code": "186441708",
"telephone_number": "570-693-1578",
"fax_number": "570-693-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLASE",
"first_name": "ROBERT",
"middle_name": "DEWEY",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-23",
"last_updated": "2014-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG000804",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000901188",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wyoming, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.