Individual provider Active NPI

Robert Harrison Mulgrew, OD

  • Optometrist
  • Tucson, AZ
National Provider Identifier
1851370878
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
708 Issued in AZ
Practice address
6615 N Oracle Rd
Tucson, AZ 85704-5644
Phone
(520) 797-8000
Fax
(520) 797-8008
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 708 AZ Primary

Addresses

Primary practice location

6615 N Oracle Rd
Tucson, AZ 85704-5644

Mailing address

6615 N Oracle Rd
Tucson, AZ 85704-5644
Phone (520) 797-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20040209000385 AZ Practitioner - Optometry 6709770126 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
708AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
John H McDougall OD Arizona PC Optometrist CurrentSince Dec 14, 2019 Accepting new patients
Luxottica of America Inc Past Accepting new patients

Locations

13125 N La Montana Dr
Ste 1
Fountain Hls, AZ 85268
Phone (480) 816-0102

6615 N Oracle Rd
Tucson, AZ 85704
Phone (520) 797-8000

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": "1552953600000",
    "number": "1851370878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 N ORACLE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857045644",
            "telephone_number": "520-797-8000",
            "fax_number": "520-797-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6615 N ORACLE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857045644",
            "telephone_number": "520-797-8000",
            "fax_number": "520-797-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULGREW",
        "first_name": "ROBERT",
        "middle_name": "HARRISON",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.