Robert E. Elliott, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2658 Issued in WI

Practice address

2722 Old Mill Dr
Racine, WI 53405-1320

Phone

(262) 632-2020

Fax

(262) 632-7085

NPI assigned

Jan 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1992

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Elliott Vision Center Inc.

  • Optometrist
  • Racine, WI
  • NPI 1669590006
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669450151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 OLD MILL DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534051320",
            "telephone_number": "262-632-2020",
            "fax_number": "262-632-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 OLD MILL DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534051320",
            "telephone_number": "262-632-2020",
            "fax_number": "262-632-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "ROBERT",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38620900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric James Eitel, PHARMD
• Paul M Elcano, DDS
• Houssam Elchekha, DDS
• Sandra L. Elfering, M.D.
• Elliott Vision Center Inc.
• Lakazia Ellis
• Jose Lonappan Eluvathingal, PHD
• Allison L Emery, DMD
• Michelle Englund
• Enhanced Medical Imaging

• Optometrist in Racine, WI
• Providers in Racine, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.