Individual provider Active NPI

Robert Kummer, O.D.

  • Optometrist
  • Los Angeles, CA
National Provider Identifier
1568469732
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5550T Issued in CA
Practice address
1421 S Robertson Blvd
Los Angeles, CA 90035-3401
Phone
(310) 274-0653
Fax
(310) 274-0360
NPI assigned
Jul 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5550T CA Primary

Addresses

Primary practice location

1421 S Robertson Blvd
Los Angeles, CA 90035-3401

Mailing address

1421 S Robertson Blvd
Los Angeles, CA 90035-3401
Phone (310) 274-0653

Other identifiers 2

IdentifierTypeStateIssuer
P00361101OtherCARAILROAD MEDICARE
SD0055500MedicaidCA

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
5550TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Robertson Optometry, PC Optometrist CurrentSince Dec 22, 2019 Accepting new patients

Locations

1421 S Robertson Blvd
Los Angeles, CA 90035
Phone (310) 274-0653

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": "1120435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1568469732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900353401",
            "telephone_number": "310-274-0653",
            "fax_number": "310-274-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900353401",
            "telephone_number": "310-274-0653",
            "fax_number": "310-274-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMMER",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-04",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5550T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00361101",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0055500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.