Individual provider Active NPI

Robert E Miller, OD

  • Optometrist
  • East Greenwich, RI
National Provider Identifier
1477580553
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODTG00610 Issued in RI
Practice address
5393 Post Rd
East Greenwich, RI 02818-3023
Phone
(401) 884-6066
Fax
(401) 885-2142
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODTA00309 RI
Optometrist 152W00000X ODTG00610 RI Primary

Addresses

Primary practice location

5393 Post Rd
East Greenwich, RI 02818-3023

Mailing address

10 Orms St
Suite 110
Providence, RI 02904-2228
Phone (401) 453-0666

Other identifiers 1

IdentifierTypeStateIssuer
9009829MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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

Enrollment IDStateProvider typePAC IDDetails
I20060802000383 RI Practitioner - Optometry 4183637481 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODTA00309RIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Associates Inc Optometrist CurrentSince Oct 1, 2024 Accepting new patients
Vision Associates Inc Optometrist Past Accepting new patients

Locations

5600 Post Rd
Unit 111
East Greenwich, RI 02818
Phone (401) 885-2166

148 Social St
Woonsocket, RI 02895
Phone (401) 769-2755

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1477580553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 ORMS ST",
            "address_2": "SUITE 110",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042228",
            "telephone_number": "401-453-0666",
            "fax_number": "401-453-9619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5393 POST RD",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028183023",
            "telephone_number": "401-884-6066",
            "fax_number": "401-885-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ROBERT",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTA00309",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "RI",
            "license": "ODTG00610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9009829",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Greenwich, RI

Sources for this page

Verify at the official NPI Registry.