Individual provider Active NPI

Scott Wesley Robertson, OD

  • Optometrist
  • Green River, WY
National Provider Identifier
1942048905
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
461T Issued in WY
Practice address
170 Commerce Dr Ste C
Green River, WY 82935-6156
Phone
(307) 875-3399
NPI assigned
Jul 16, 2024
Last updated
Aug 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 461T WY Primary

Addresses

Primary practice location

170 Commerce Dr Ste C
Green River, WY 82935-6156

Mailing address

170 Commerce Dr Ste C
Green River, WY 82935-6156
Phone (307) 399-6529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20240730001010 WY Practitioner - Optometry 0941747786 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

170 Commerce Dr
Suite C
Green River, WY 82935-6156
Phone (307) 875-3399

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
461TWYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Larsen Vision Clinic PC Optometrist CurrentSince Jul 1, 2024 Accepting new patients
Wyoming Vision Collective Desert View Eye Care Optometrist CurrentSince Jul 9, 2025 Accepting new patients

Locations

3400 E 2nd St
Casper, WY 82609
Phone (307) 266-9988

170 Commerce Dr
Ste C
Green River, WY 82935
Phone (307) 875-3399

Interoperability endpoints

  • Direct secure messaging: scottrobertsonod@direct.revolutionehr.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1942048905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 COMMERCE DR STE C",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829356156",
            "telephone_number": "307-399-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 COMMERCE DR STE C",
            "city": "GREEN RIVER",
            "state": "WY",
            "postal_code": "829356156",
            "telephone_number": "307-875-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "SCOTT",
        "middle_name": "WESLEY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-16",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WY",
            "license": "461T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green River, WY

Sources for this page

Verify at the official NPI Registry.