Individual provider Active NPI

Robert A Foote, OD

  • Optometrist
  • Traverse City, MI
National Provider Identifier
1891857017
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
RF002960 Issued in MI
Practice address
5199 N Royal Dr
Traverse City, MI 49684-9201
Phone
(231) 935-8101
Fax
(231) 935-0955
NPI assigned
Dec 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X RF002960 MI Primary

Addresses

Primary practice location

5199 N Royal Dr
Traverse City, MI 49684-9201

Mailing address

5199 N Royal Dr
Traverse City, MI 49684-9201
Phone (231) 935-8101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040525001237 MI Practitioner - Optometry 3173504339 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ferris State UniversityGroup PAC ID 3971572124, 27 clinicians

Practice addresses (Care Compare)

1124 S State St
Big Rapids, MI 49307-2256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RF002960MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Traverse City Ophthalmology PLLC CurrentSince Jul 6, 2022 Accepting new patients

Locations

419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500

5199 N Royal Dr
Traverse City, MI 49684
Phone (231) 486-0230

3830 W Front St
Traverse City, MI 49684
Phone (231) 929-3888

Interoperability endpoints

  • Direct secure messaging: rfoote@tce.intellechartdirect.net

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1891857017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5199 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849201",
            "telephone_number": "231-935-8101",
            "fax_number": "231-935-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5199 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849201",
            "telephone_number": "231-935-8101",
            "fax_number": "231-935-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOOTE",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "RF002960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.