Active NPI
Daniel Allen Robison, OD
- Optometrist
- Lake Oswego, OR
National Provider Identifier
1487641080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2371AT
- Practice address
- 17777 SW Lower Boones Ferry Rd
Lake Oswego, OR 97035-5398 - Phone
- (503) 635-8819
- Fax
- (503) 635-1512
- NPI assigned
- Sep 29, 2005
- Last updated
- Nov 23, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | 2371AT | OR | Primary |
Addresses
Primary practice location
17777 SW Lower Boones Ferry Rd
Lake Oswego, OR 97035-5398
Mailing address
17777 Lower Boones Ferry Rd
Lake Oswego, OR 97035-5398
Phone (503) 635-8819
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 138813 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2371AT | OR | MD | Optometrist |
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": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479859200000",
"number": "1487641080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17777 LOWER BOONES FERRY RD",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970355398",
"telephone_number": "503-635-8819",
"fax_number": "503-635-1512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17777 SW LOWER BOONES FERRY RD",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970355398",
"telephone_number": "503-635-8819",
"fax_number": "503-635-1512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBISON",
"first_name": "DANIEL",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-29",
"last_updated": "2016-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "2371AT",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "138813",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.