Individual provider Active NPI

Robert Rose, OD

  • Optometrist
  • Mount Kisco, NY
National Provider Identifier
1508943648
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT003481-1 Issued in NY
Practice address
69 S Moger Ave
Mount Kisco, NY 10549-2217
Phone
(914) 666-5870
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

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 VUT003481-1 NY Primary

Addresses

Primary practice location

69 S Moger Ave
Mount Kisco, NY 10549-2217

Mailing address

69 S Moger Ave
Mount Kisco, NY 10549-2217
Phone (914) 666-5870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VUT003481-1NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ameet Goyal MD PC PastSince Sep 6, 2016 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508943648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 S MOGER AVE",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105492217",
            "telephone_number": "914-666-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 S MOGER AVE",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105492217",
            "telephone_number": "914-666-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "VUT003481-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.