Organization Active NPI

Robert W Moses OD Professional Corp.

  • Eyewear Supplier
  • Merrillville, IN
National Provider Identifier
1699890111
Registry record updated Oct 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
18001579 Issued in IN
Legal business name
ROBERT W MOSES OD PROFESSIONAL CORP.
Doing business as
Moses EyeCare Centers
Practice address
70 E 68TH PL
Merrillville, IN 46410-3506
Phone
(219) 736-2020
Fax
(219) 769-3884
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2010

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

Authorized official

Name
Dr. Robert William Moses, ODNPI 1417938010
Title
President
Phone
(219) 736-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 18001579 IN Primary

Addresses

Primary practice location

70 E 68TH PL
Merrillville, IN 46410-3506

Mailing address

70 E 68TH PL
Merrillville, IN 46410-3506
Phone (219) 736-2020

Other names 1

  • Moses EyeCare Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930049273 IN DME Supplier - Physician - Optometrist 9436138617 Practice locations: Merrillville, IN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Robert W Moses OD Professional Corp70 E 68TH PL, Merrillville, IN 46410-3506(219) 736-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Apr 1, 2000

National Provider Directory

National Provider Directory
Tax ID family
Robert W Moses OD Professional Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

70 E 68th Pl
Merrillville, IN 46410
Phone (219) 736-2020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286841600000",
    "number": "1699890111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 E 68TH PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464103506",
            "telephone_number": "219-736-2020",
            "fax_number": "219-769-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 E 68TH PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464103506",
            "telephone_number": "219-736-2020",
            "fax_number": "219-769-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT W MOSES OD PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2010-10-12",
        "status": "A",
        "authorized_official_last_name": "MOSES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-736-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IN",
            "license": "18001579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moses EyeCare Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.