Engstrom Eye Center LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

8525 Issued in NM

Legal business name

ENGSTROM EYE CENTER LLC

Practice address

342 Sherrill LN
Roswell, NM 88201-5819

Phone

(575) 625-0123

Fax

(575) 625-0131

NPI assigned

Mar 10, 2008

Last updated

Apr 10, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul F Engstrom, MDNPI 1003884602

Title

Owner

Phone

(575) 625-0123

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul F Engstrom, M.D.

  • Ophthalmology Physician
  • Roswell, NM
  • NPI 1003884602
  Medicare reassignment Care Compare group NPD Authorized official
• Grace M Sally Mellgren, M.D.

  • Ophthalmology Physician
  • Roswell, NM
  • NPI 1184709339
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1013187798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 SHERRILL LN",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015819",
            "telephone_number": "575-625-0123",
            "fax_number": "575-625-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 SHERRILL LN",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015819",
            "telephone_number": "575-625-0123",
            "fax_number": "575-625-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENGSTROM EYE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "ENGSTROM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-625-0123",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NM",
            "license": "8525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Embrace, Inc.
• Lynelle Marie Endsley, NP
• Sidney Clyde England, PA-C
• Bobby English, R.PH.
• Raymond Dale English, RPH
• Paul F Engstrom, M.D.
• Enmu Roswell
• Enmu-Roswell
• Enmu-Roswell School Based Health Center
• Stacey Ennis

• Ophthalmology Physician in Roswell, NM
• Providers in Roswell, NM by specialty
• Ophthalmology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.