Individual provider Active NPI

Daniel Allen Robison, OD

  • Optometrist
  • Lake Oswego, OR
National Provider Identifier
1487641080
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2371AT Issued in OR
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, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
138813MedicaidOR

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111229000043 OR Practitioner - Optometry 6002082823 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2371ATORMDOptometrist

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

Verify at the official NPI Registry.