Individual provider Active NPI

Rolf Gerchberg, D.O.

  • Optometrist
  • Chicopee, MA
National Provider Identifier
1982601092
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
MA4507 Issued in MA
Practice address
444 Montgomery St
Chicopee, MA 01020-1969
Phone
(413) 594-3111
Fax
(413) 598-7115
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X MA4507 MA Primary

Addresses

Primary practice location

444 Montgomery St
Chicopee, MA 01020-1969

Mailing address

444 Montgomery St
Chicopee, MA 01020-1969
Phone (413) 594-3111

Other identifiers 1

IdentifierTypeStateIssuer
706884MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050801000277 MA Practitioner - Optometry 4486680709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
MA4507MAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc Past Accepting new patients
Aspen Enterprises, Inc. Optometrist PastSince Jan 12, 2004 Accepting new patients

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303689600000",
    "number": "1982601092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 MONTGOMERY ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010201969",
            "telephone_number": "413-594-3111",
            "fax_number": "413-598-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 MONTGOMERY ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010201969",
            "telephone_number": "413-594-3111",
            "fax_number": "413-598-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERCHBERG",
        "first_name": "ROLF",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2011-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "MA4507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "706884",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicopee, MA

Sources for this page

Verify at the official NPI Registry.