Individual provider Active NPI

Robert M Burley, O.D.

  • Optometrist
  • Cleveland, OH
National Provider Identifier
1952376006
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3594 T197 Issued in OH
Practice address
2351 E 22ND St
Cleveland, OH 44115-3111
Phone
(216) 363-2513
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3594 T197 OH Primary

Addresses

Primary practice location

2351 E 22ND St
Cleveland, OH 44115-3111

Mailing address

5028 Woodview Dr
Vermilion, OH 44089-1666
Phone (440) 967-3937

Other practice location 1

5012 Liberty Ave
Vermilion, OH 44089-1408
Phone (440) 967-3937

Other identifiers 1

IdentifierTypeStateIssuer
0530429MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3594 T197OHMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1952376006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5028 WOODVIEW DR",
            "city": "VERMILION",
            "state": "OH",
            "postal_code": "440891666",
            "telephone_number": "440-967-3937",
            "fax_number": "403-721-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 E 22ND ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153111",
            "telephone_number": "216-363-2513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5012 Liberty Ave",
            "address_purpose": "LOCATION",
            "city": "Vermilion",
            "state": "OH",
            "postal_code": "440891408",
            "country_code": "US",
            "telephone_number": "440-967-3937",
            "fax_number": "440-967-5106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURLEY",
        "first_name": "ROBERT",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3594 T197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0530429",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.