Robert F Dundervill III, M.D.

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

18154 Issued in WV

Practice address

331 Laidley St
Ste 301
Charleston, WV 25301-1605

Phone

(304) 346-4400

Fax

(304) 346-0704

NPI assigned

Jun 9, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Virginia Commonwealth University, School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Retina Consultants PLLCGroup PAC ID 3375636178, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Retina Consultants, PLLC

  • Retina Specialist (Ophthalmology) Physician
  • Charleston, WV
  • NPI 1902800758
  Medicare reassignment Care Compare group Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Herbert J. Thomas Memorial Hospital Association

  • General Acute Care Hospital
  • South Charleston, WV
  • NPI 1316925506
  Care Compare affiliation

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1497759229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3970",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253393970",
            "telephone_number": "304-346-4400",
            "fax_number": "304-346-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 LAIDLEY ST",
            "address_2": "STE 301",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011605",
            "telephone_number": "304-346-4400",
            "fax_number": "304-346-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNDERVILL",
        "first_name": "ROBERT",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "KY",
            "license": "30257",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "OH",
            "license": "35094593",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WV",
            "license": "18154",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "WV",
            "license": "18154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0976832",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096030000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64302573",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janelda Rae Duncan, PA-C
• Kelsey Duncan
• Kimberly Duncan
• Robert B Duncan, PHARMD
• Ryan Duncan
• McKenzie Dunfee
• Coley Dunigan
• Valerie A. Dunigan, PHARM.D.
• Brittany Elizabeth Dunlap, APRN-CRNA
• Chasity Dawn Dunlap

• Retina Specialist (Ophthalmology) Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Retina Specialist (Ophthalmology) Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.

Verify at the official NPI Registry.