Organization Active NPI

Robert R Negrete OD PC

  • Optometrist
  • Marshalltown, IA
National Provider Identifier
1861590325
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2015T Issued in IA
Legal business name
ROBERT R NEGRETE OD PC
Practice address
116 W Main St
Marshalltown, IA 50158-5844
Phone
(641) 753-5042
Fax
(641) 753-5292
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Authorized official

Name
Dr. Robert R Negrete, O.D.NPI 1447218003
Title
Owner
Phone
(319) 461-0038

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 2015T IA Primary

Addresses

Primary practice location

116 W Main St
Marshalltown, IA 50158-5844

Mailing address

116 W Main St
Marshalltown, IA 50158-5844
Phone (641) 753-5042

Other identifiers 3

IdentifierTypeStateIssuer
4110973MedicaidIA
53102OtherIADR NEGRETE BCBS #
P00291954OtherIADR NEGRETE RR MEDICARE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060217000293 IA Part B Supplier - Clinic/Group Practice 1355356981 Receives reassigned benefits from 1 practitioner
Practice locations: Ankeny, IA; Marshalltown, IA

National Provider Directory

National Provider Directory

Locations

301 S Iowa Ave
Washington, IA 52353
Phone (319) 653-2371

221 N 2nd Ave
Washington, IA 52353
Phone (319) 653-4558

519 Court St
Williamsburg, IA 52361
Phone (319) 668-8000

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545264000000",
    "number": "1861590325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 W MAIN ST",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501585844",
            "telephone_number": "641-753-5042",
            "fax_number": "641-753-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W MAIN ST",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501585844",
            "telephone_number": "641-753-5042",
            "fax_number": "641-753-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT R NEGRETE OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-12-20",
        "status": "A",
        "authorized_official_last_name": "NEGRETE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-461-0038",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "2015T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4110973",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR NEGRETE BCBS #",
            "identifier": "53102",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR NEGRETE RR MEDICARE #",
            "identifier": "P00291954",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshalltown, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; 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.