Robert Victor Haeder II, O.D.
Individual provider Active NPI Optometrist · Sioux Falls, SD
NPI 1922068873 · NPPES record last updated Jun 17, 2020
Key facts
- NPI
- 1922068873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- T-462 (SD)
- Practice address
- 5012 S Bur Oak PL
Sioux Falls, SD 57108-2228 - Phone
- (605) 361-1680
- Fax
- (605) 361-1590
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University Alabama Birmingham - School of Optometry, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dakota Vision Center LLC
Practice addresses (Care Compare)
5012 S Bur Oak PL
Sioux Falls, SD 57108-2228
Phone (605) 361-1680
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 52 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051123000086 | SD | Practitioner - Optometry | 6204855026 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T-462 | SD | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dakota Vision Center, LLC | Optometrist | Current |
Accepting new patients |
| Dakota Vision Center, LLC | Optometrist | Current |
Accepting new patients |
Locations
1100 S Highline Pl
Sioux Falls, SD 57110
Phone (605) 271-0164
3401 S Kelley Ave
Sioux Falls, SD 57106
Phone (605) 274-0217
5012 S Bur Oak Pl
Sioux Falls, SD 57108
Phone (605) 338-8010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | T-462 | SD | Yes |
Addresses
Primary practice location
5012 S Bur Oak PL
Sioux Falls, SD 57108-2228
Mailing address
5012 S Bur Oak PL
Sioux Falls, SD 57108-2228
Phone (605) 361-1680
Other practice location 1
1100 S Highline Pl
Sioux Falls, SD 57110-1001
Phone (605) 271-0464
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9202072 | Medicaid | SD |
Other providers in Sioux Falls, SD
- Timothy Allen Habeck
- Sarah Haberman
- Keely Marie Hack
- William Hadden
- Charity Haddican
- Jess Haensel
- Geoffrey F Haft
- Sydney Haga
- Keegan Kiel Hage
- Hagen Chiropractic Clinic Prof LLC
All providers in Sioux Falls, SD · Optometrist in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.