Organization Active NPI

Robert R. Mauger, O.D., P.a.

  • Optometrist
  • Altamonte Springs, FL
National Provider Identifier
1831469162
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 1854 Issued in FL
Legal business name
ROBERT R. MAUGER, O.D., P.A.
Practice address
120 Pine Needle LN
Altamonte Springs, FL 32714-5814
Phone
(407) 340-9080
NPI assigned
Jan 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Authorized official

Name
Dr. Robert R. Mauger, O.D.
Title
President
Phone
(407) 340-9080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC 1854 FL Primary

Addresses

Primary practice location

120 Pine Needle LN
Altamonte Springs, FL 32714-5814

Mailing address

120 Pine Needle LN
Altamonte Springs, FL 32714-5814
Phone (407) 340-9080

Other identifiers 1

IdentifierTypeStateIssuer
078305600MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120112000352 FL Part B Supplier - Clinic/Group Practice 5294902383 Receives reassigned benefits from 1 practitioner
Practice locations: Orlando, FL; Altamonte Springs, FL; Palm Bay, FL; Port St. Lucie, FL; Rockledge, FL; Sebring, FL; St. Cloud, FL; Tallahassee, FL…

National Provider Directory

National Provider Directory

Locations

175 Villa Nueva Ave NE
Palm Bay, FL 32907
Phone (313) 574-2965

5405 Babcock St NE
#N
Palm Bay, FL 32905
Phone (321) 722-0660

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325548800000",
    "number": "1831469162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PINE NEEDLE LN",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327145814",
            "telephone_number": "407-340-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PINE NEEDLE LN",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327145814",
            "telephone_number": "407-340-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT R. MAUGER, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-03",
        "last_updated": "2012-01-03",
        "status": "A",
        "authorized_official_last_name": "MAUGER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-340-9080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 1854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078305600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.