Individual provider Active NPI

Philip Raber, O.D.

  • Optometrist
  • Kidron, OH
National Provider Identifier
1487622593
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4582 Issued in OH
Practice address
12990 Emerson Rd.
Kidron, OH 44636-0010
Phone
(330) 857-0123
Fax
(330) 857-0246
NPI assigned
Mar 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4582 OH Primary

Addresses

Primary practice location

12990 Emerson Rd.
Kidron, OH 44636-0010

Mailing address

PO Box 10
Kidron, OH 44636-0010
Phone (330) 857-0123

Other identifiers 1

IdentifierTypeStateIssuer
2312483MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060217000074 OH Practitioner - Optometry 0042231847 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Insight Vision Care IncGroup PAC ID 0244302511, 7 clinicians

Practice addresses (Care Compare)

3693 Kidron Rd
Kidron, OH 44636
Phone (330) 857-0123

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4582OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Raber Eye Care Inc Optometrist CurrentSince Apr 15, 2002 Accepting new patients
Insight Vision Care, Inc. Optometrist CurrentSince Jul 1, 2025 Accepting new patients

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487622593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "KIDRON",
            "state": "OH",
            "postal_code": "446360010",
            "telephone_number": "330-857-0123",
            "fax_number": "330-857-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12990 EMERSON RD.",
            "city": "KIDRON",
            "state": "OH",
            "postal_code": "446360010",
            "telephone_number": "330-857-0123",
            "fax_number": "330-857-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABER",
        "first_name": "PHILIP",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "4582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2312483",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kidron, OH

Sources for this page

Verify at the official NPI Registry.