Individual provider Active NPI

Robert P Burrows, O.D.

  • Optometrist
  • Chehalis, WA
National Provider Identifier
1740389519
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00001416 Issued in WA
Practice address
1179 S Market Blvd
Chehalis, WA 98532-3427
Phone
(360) 748-9228
Fax
(360) 748-4617
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00001416 WA Primary
Optometrist 152W00000X 00001416 WA
Corneal and Contact Management Optometrist 152WC0802X OD00001416 WA

Addresses

Primary practice location

1179 S Market Blvd
Chehalis, WA 98532-3427

Mailing address

PO Box 1126
Chehalis, WA 98532-0169
Phone (360) 748-9228

Other identifiers 6

IdentifierTypeStateIssuer
2030237MedicaidWA
0036580OtherWAL&I CLINIC GROUP NUMBER
0052484OtherWAL&I RPBURROWS ONLY
2046506MedicaidWA
BU0836OtherWAREGENCE RPBURROWS ONLY
HE7836OtherWAREGENCE CLINIC NUMBER

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100114000809 WA Practitioner - Optometry 7810079795 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00001416WAMDOptometrist
OD00001416WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Washington Professional PC Optometrist CurrentSince Aug 30, 2023 Accepting new patients

Locations

12310 NE 8th St
Ste 101
Bellevue, WA 98005
Phone (425) 455-0001

1179 S Market Blvd
Chehalis, WA 98532
Phone (360) 748-9228

1098 Alder Ave
Marysville, WA 98270
Phone (360) 659-6255

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1740389519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1126",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320169",
            "telephone_number": "360-748-9228",
            "fax_number": "360-748-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 S MARKET BLVD",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323427",
            "telephone_number": "360-748-9228",
            "fax_number": "360-748-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROWS",
        "first_name": "ROBERT",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001416",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "00001416",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WA",
            "license": "OD00001416",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030237",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CLINIC GROUP NUMBER",
            "identifier": "0036580",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I RPBURROWS ONLY",
            "identifier": "0052484",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2046506",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE RPBURROWS ONLY",
            "identifier": "BU0836",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE CLINIC NUMBER",
            "identifier": "HE7836",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

Verify at the official NPI Registry.