Individual provider Active NPI

Robert A Colon, O.D.

  • Optometrist
  • Elko, NV
National Provider Identifier
1821096991
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
149 Issued in NV
Practice address
2209 N 5TH St
Elko, NV 89801-2458
Phone
(775) 738-8491
Fax
(775) 738-3313
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 149 NV Primary
Low Vision Rehabilitation Optometrist 152WL0500X 149 NV
Pediatric Optometrist 152WP0200X 149 NV
Sports Vision Optometrist 152WS0006X 149 NV
Occupational Vision Optometrist 152WX0102X 149 NV
Corneal and Contact Management Optometrist 152WC0802X 149 NV

Addresses

Primary practice location

2209 N 5TH St
Elko, NV 89801-2458

Mailing address

2209 N 5TH St
Elko, NV 89801-2458
Phone (775) 738-8491

Other identifiers 6

IdentifierTypeStateIssuer
410021227OtherNVRR MEDICARE
627631OtherNVBCBS MEDIGAP
0373120001OtherNVDMERC PIN
00010029440OtherNVTAT
WCHMJOtherNVGROUP MEDICARE PIN
002504520MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20101229000040 NV Practitioner - Optometry 4486740974 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149NVMDSports Vision Optometrist

Interoperability endpoints

  • Direct secure messaging: rcolon@colonalleman.eyefinity-direct.com

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1821096991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 N 5TH ST",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012458",
            "telephone_number": "775-738-8491",
            "fax_number": "775-738-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 N 5TH ST",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012458",
            "telephone_number": "775-738-8491",
            "fax_number": "775-738-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "149",
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NV",
            "license": "149",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NV",
            "license": "149",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "NV",
            "license": "149",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "NV",
            "license": "149",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NV",
            "license": "149",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410021227",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MEDIGAP",
            "identifier": "627631",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC PIN",
            "identifier": "0373120001",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAT",
            "identifier": "00010029440",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PIN",
            "identifier": "WCHMJ",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002504520",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, NV

Sources for this page

Verify at the official NPI Registry.