Robert L Fait, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1332035 Issued in WI

Practice address

309 McHenry St
Burlington, WI 53105-2123

Phone

(262) 763-0117

Fax

(262) 763-0119

NPI assigned

Jun 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1972548386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630",
            "address_2": "309 MCHENRY ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531050630",
            "telephone_number": "262-763-0117",
            "fax_number": "262-763-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 MCHENRY ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531052123",
            "telephone_number": "262-763-0117",
            "fax_number": "262-763-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIT",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1332035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38569200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karli C Eterno, DPT
• Anna Teresa Evans, LCPC, CADC
• Eye Physicians & Surgeons SC
• Eye Physicians and Surgeons SC
• Eye Physicians and Surgeons SC
• Holly Fales, COTA
• Family Vision & Contact Lens Centers, S.C.
• Family Vision & Contact Lens Centers, S.C.
• David Feather, PT, DPT
• Scott Michael Ferguson, DC,ATC

• Optometrist in Burlington, WI
• Providers in Burlington, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.