NPIMap

Organization Active NPI

Robert W Moses OD Professional Corp.

Doing business as Moses EyeCare Centers

  • Eyewear Supplier
  • Lowell, IN
National Provider Identifier
1790800217
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
18001579 Issued in IN
Legal business name
ROBERT W MOSES OD PROFESSIONAL CORP.
Doing business as
Moses EyeCare Centers
Practice address
117 Deanna Dr
Lowell, IN 46356-2402
Phone
(219) 696-8077
NPI assigned
Mar 21, 2007
Last updated
Oct 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Authorized official

Name
Dr. Robert William Moses, ODNPI 1417938010
Title
President
Phone
(219) 736-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 18001579 IN Primary

Addresses

Primary practice location

117 Deanna Dr
Lowell, IN 46356-2402

Mailing address

117 Deanna Dr
Lowell, IN 46356-2402
Phone (219) 696-8077

Other names 1

  • Moses EyeCare Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040720000769 IN Part B Supplier - Clinic/Group Practice 9436138617 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Crown Point, IN; Valparaiso, IN; Saint John, IN; Portage, IN; Merrillville, IN; Lowell, IN; Hammond, IN; Griffith, IN…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

117 Deanna Dr
Lowell, IN 46356
Phone (219) 696-8077

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286928000000",
    "number": "1790800217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 DEANNA DR",
            "city": "LOWELL",
            "state": "IN",
            "postal_code": "463562402",
            "telephone_number": "219-696-8077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 DEANNA DR",
            "city": "LOWELL",
            "state": "IN",
            "postal_code": "463562402",
            "telephone_number": "219-696-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT W MOSES OD PROFESSIONAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2010-10-13",
        "status": "A",
        "authorized_official_last_name": "MOSES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-736-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IN",
            "license": "18001579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moses EyeCare Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lowell, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.