Individual provider Active NPI

Robert A Stamm, OD

  • Optometrist
  • MC Cook, NE
National Provider Identifier
1790764769
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1049 Issued in NE
Practice address
218 West D Street
MC Cook, NE 69001-3739
Phone
(308) 345-5800
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1049 NE Primary
Optometrist 152W00000X 1636 KS

Addresses

Primary practice location

218 West D Street
MC Cook, NE 69001-3739

Mailing address

PO Box 1808
MC Cook, NE 69001-1808
Phone (308) 345-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, NE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040409000236 KS Practitioner - Optometry 2769474303 Reassigns benefits to 1 organization
I20080219000760 NE Practitioner - Optometry 2769474303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifetime Eyecare, P.C.Group PAC ID 4981696523, 3 clinicians

Practice addresses (Care Compare)

218 W D St
McCook, NE 69001-3664
Phone (308) 345-5800

419 Seminole Dr
MC Cook, NE 69001-2264

PO Box
Suite 1808
MC Cook, NE 69001

Merit-based Incentive Payment System (MIPS)

Final score
42.04 of 100Reported as group
Quality
84.07
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1049NEMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifetime Eyecare, P.C. Optometrist CurrentSince Sep 2, 1994 Accepting new patients
County of Red Willow PastSince Sep 2, 1994 Accepting new patients

Locations

105 S Penn Ave
Oberlin, KS 67749
Phone (308) 345-5800

218 W D St
McCook, NE 69001
Phone (308) 345-5800

Organizations & group practices 2

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1790764769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1808",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690011808",
            "telephone_number": "308-345-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 WEST D STREET",
            "city": "MC COOK",
            "state": "NE",
            "postal_code": "690013739",
            "telephone_number": "308-345-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMM",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1049",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1636",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Cook, NE

Sources for this page

Verify at the official NPI Registry.