Individual provider Active NPI

Robert Donat Gillett, O.D.

  • Optometrist
  • Porterville, CA
National Provider Identifier
1740275619
Registry record updated Mar 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT6035TPL Issued in CA
Practice address
418 W Putnam Ave
Porterville, CA 93257-3321
Phone
(559) 784-4063
Fax
(559) 784-2069
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT6035TPL CA Primary

Addresses

Primary practice location

418 W Putnam Ave
Porterville, CA 93257-3321

Mailing address

418 W Putnam Ave
Porterville, CA 93257-3321
Phone (559) 784-4063

Other identifiers 1

IdentifierTypeStateIssuer
SD0060350MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20060103000577 CA Practitioner - Optometry 8820010952 Practice locations: Porterville, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

418 W Putnam Ave
Porterville, CA 93257-3321
Phone (559) 784-4063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT6035TPLCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1740275619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 W PUTNAM AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932573321",
            "telephone_number": "559-784-4063",
            "fax_number": "559-784-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 W PUTNAM AVE",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932573321",
            "telephone_number": "559-784-4063",
            "fax_number": "559-784-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETT",
        "first_name": "ROBERT",
        "middle_name": "DONAT",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT6035TPL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0060350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Porterville, CA

Sources for this page

Verify at the official NPI Registry.