Individual provider Active NPI

Robin Eco Bautista, OD

  • Optometrist
  • Eugene, OR
National Provider Identifier
1710186887
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3260ATI Issued in OR
Practice address
360 S Garden Way Ste 250
Eugene, OR 97401-8175
Phone
(541) 343-5000
Fax
(541) 344-9478
NPI assigned
Jul 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3260ATI OR Primary

Addresses

Primary practice location

360 S Garden Way Ste 250
Eugene, OR 97401-8175

Mailing address

360 S Garden Way Ste 250
Eugene, OR 97401-8175
Phone (541) 343-5000

Other practice location 1

1125 Darlene Ln
Eugene, OR 97401-1601
Phone (541) 343-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20120815000656 OR Practitioner - Optometry 9234327396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Clear Vision Institute PCGroup PAC ID 9931192515, 6 clinicians

Practice addresses (Care Compare)

1125 Darlene LN
Suite 100
Eugene, OR 97401-1601
Phone (541) 687-2441

Merit-based Incentive Payment System (MIPS)

Final score
90.49 of 100Reported as group
Quality
90.85
Improvement activities
40
Cost
80.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3260ATIORMDOptometrist

Interoperability endpoints

  • Direct secure messaging: rbautistaod@pcvi.direct.eyemdemr.com

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, 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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1710186887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 S GARDEN WAY STE 250",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018175",
            "telephone_number": "541-343-5000",
            "fax_number": "541-344-9478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S GARDEN WAY STE 250",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018175",
            "telephone_number": "541-343-5000",
            "fax_number": "541-344-9478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 Darlene Ln",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974011601",
            "country_code": "US",
            "telephone_number": "541-343-5000",
            "fax_number": "541-344-9478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "ROBIN",
        "middle_name": "ECO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3260ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.