Active NPI
Robert Dean Williams, MD
- Ophthalmology Physician
- Friday Harbor, WA
National Provider Identifier
1639171291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD00015265
- Practice address
- 470 Spring Street
Ste 200
Friday Harbor, WA 98250 - Phone
- (360) 378-3937
- Fax
- (360) 282-6871
- NPI assigned
- Aug 12, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 27856 | KY | |
| Ophthalmology Physician | 207W00000X | 01042740 | IN | |
| Ophthalmology Physician | 207W00000X | MD00015265 | WA | Primary |
Addresses
Primary practice location
470 Spring Street
Ste 200
Friday Harbor, WA 98250
Mailing address
89 Wilks Way
Friday Harbor, WA 98250-6049
Phone (502) 458-9004
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180019058 | Other | KY | MEDICARE RAILROAD |
| 0800308 | Other | UNITED HEALTHCARE | |
| 100380330A | Medicaid | IN | |
| K001342 | Other | KY | TRICARE |
| 1051979 | Medicaid | KY | |
| 000000062218 | Other | KY | ANTHEM |
| 100380300B | Medicaid | IN | |
| 4227781 | Other | AETNA | |
| 917224 | Other | BLOCK VISION | |
| 64278567 | Medicaid | KY | |
| 000000042394 | Other | IN | ANTHEM |
| 180017926 | Other | IN | MEDICARE RAILROAD |
| I005632 | Other | IN | TRICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111114000543 | WA | Practitioner - Ophthalmology | 9436291523 | Practice locations: Friday Harbor, WA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27856 | KY | MD | Ophthalmology Physician |
| MD00015265 | WA | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lloyd R. Taustine PC | Ophthalmology | Past | Accepting new patients |
| Lloyd R Taustine PC | Ophthalmology | Past | Accepting new patients |
Organizations & group practices 2
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": "1123804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332892800000",
"number": "1639171291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 WILKS WAY",
"city": "FRIDAY HARBOR",
"state": "WA",
"postal_code": "982506049",
"telephone_number": "502-458-9004",
"fax_number": "360-282-6871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 SPRING STREET",
"address_2": "STE 200",
"city": "FRIDAY HARBOR",
"state": "WA",
"postal_code": "98250",
"telephone_number": "360-378-3937",
"fax_number": "360-282-6871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "ROBERT",
"middle_name": "DEAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-12",
"last_updated": "2012-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "KY",
"license": "27856",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IN",
"license": "01042740",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "WA",
"license": "MD00015265",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "180019058",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0800308",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100380330A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "K001342",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1051979",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000062218",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100380300B",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4227781",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLOCK VISION",
"identifier": "917224",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64278567",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000042394",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "180017926",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "I005632",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Friday Harbor, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.