Individual provider Active NPI

Robert Ryan Powell, O.D.

  • Optometrist
  • Erie, CO
National Provider Identifier
1558506402
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0002956 Issued in CO
Practice address
893 Shuttleworth Dr
Erie, CO 80516-7242
Phone
(515) 306-2786
NPI assigned
Dec 6, 2008
Last updated
Sep 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002447 IA
Optometrist 152W00000X 0002956 CO Primary

Addresses

Primary practice location

893 Shuttleworth Dr
Erie, CO 80516-7242

Mailing address

893 Shuttleworth Dr
Erie, CO 80516-7242
Phone (515) 306-2786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20090304000084 IA Practitioner - Optometry 1759447592 Reassigns benefits to 1 organization
Practice locations: Clive, IA; West Des Moines, IA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Real Optics IncGroup PAC ID 9830218122, 6 clinicians

Practice addresses (Care Compare)

2405 Ingersoll Ave
Des Moines, IA 50312-5233
Phone (515) 244-7740

Merit-based Incentive Payment System (MIPS)

Final score
90.61 of 100Reported as group
Quality
75.16
Promoting interoperability
100
Improvement activities
40
Cost
76.87

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0002956COMDOptometrist
002447IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Real Optics Inc CurrentSince Mar 1, 2022 Accepting new patients
Real Optics Inc Past Accepting new patients
Real Optics Inc Past Accepting new patients
Real Optics Inc Past Accepting new patients

Locations

2405 Ingersoll Ave
Des Moines, IA 50312
Phone (515) 244-2338

2472 E Euclid Ave
Des Moines, IA 50317
Phone (515) 262-7555

5112 SE 14th St
Des Moines, IA 50320
Phone (515) 287-5422

9749 University Ave
Des Moines, IA 50325
Phone (515) 223-5000

4100 University Ave
Ste 106
West Des Moines, IA 50266
Phone (515) 224-1317

Organizations & group practices 4

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": "1228521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1558506402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "893 SHUTTLEWORTH DR",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805167242",
            "telephone_number": "515-306-2786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "893 SHUTTLEWORTH DR",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805167242",
            "telephone_number": "515-306-2786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "ROBERT",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-06",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "002447",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0002956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, CO

Sources for this page

Verify at the official NPI Registry.