Individual provider Active NPI

Robert Richard Wresch, M.D.

  • Ophthalmology Physician
  • Tamuning, GU
National Provider Identifier
1760555254
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
M000934 Issued in GU
Practice address
388 Ypao Rd
Tamuning, GU 96913-3701
Phone
(671) 646-8881
Fax
(671) 648-2557
NPI assigned
Nov 15, 2006
Last updated
Nov 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X M000934 GU Primary

Addresses

Primary practice location

388 Ypao Rd
Tamuning, GU 96913-3701

Mailing address

388 Ypao Rd
Tamuning, GU 96913-3701
Phone (671) 646-8881

Other identifiers 1

IdentifierTypeStateIssuer
G25667OtherCATHE MED BOARD OF CA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120220001125 GU Practitioner - Ophthalmology 7113185372 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M000934GUMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Conference Corp of Sda CurrentSince Mar 7, 1990 Accepting new patients

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1760555254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 YPAO RD",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133701",
            "telephone_number": "671-646-8881",
            "fax_number": "671-648-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 YPAO RD",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133701",
            "telephone_number": "671-646-8881",
            "fax_number": "671-648-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRESCH",
        "first_name": "ROBERT",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GU",
            "license": "M000934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE MED BOARD OF CA",
            "identifier": "G25667",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.