Physician Compare National (NPI:1730442997)

HEALTHCARE PROVIDER: TIMOTHY MADSEN ROBINSON O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1730442997
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1254589229
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160906001165
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ROBINSON
	Individual professional last name
Provider First Name	TIMOTHY
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1612 EGLIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	RAPID CITY
	Group Practice or individual's city
State	SD
	Group Practice or individual's state
Zip Code	577016111
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6053484778
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y