NPIMap

Organization Active NPI

Eye Associates of New Mexico LTD

Doing business as Eye Associates of New Mexico

  • Ophthalmology Physician
  • Gallup, NM
National Provider Identifier
1063559961
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE ASSOCIATES OF NEW MEXICO LTD
Doing business as
Eye Associates of New Mexico
Practice address
311 Nizhoni Blvd
Gallup, NM 87301
Phone
(505) 722-2268
Fax
(505) 863-2874
NPI assigned
Jan 31, 2007
Last updated
Feb 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Authorized official

Name
Michelle R. Butcher
Title
Credentialing Manager
Phone
(505) 828-4923

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

311 Nizhoni Blvd
Gallup, NM 87301

Mailing address

8801 Horizon Blvd NE
Suite 360
Albuquerque, NM 87113-1533
Phone (505) 246-2622

Other identifiers 4

IdentifierTypeStateIssuer
47951MedicaidNM
CH4370OtherNMRAILROAD MEDICARE (RRB)
K5006MedicaidNM
CN6728OtherNMRAILROAD MEDICARE (RRB)

Other names 1

  • Eye Associates of New Mexico Doing business as

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393200000000",
    "number": "1063559961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8801 HORIZON BLVD NE",
            "address_2": "SUITE 360",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131533",
            "telephone_number": "505-246-2622",
            "fax_number": "505-213-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "87301",
            "telephone_number": "505-722-2268",
            "fax_number": "505-863-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES OF NEW MEXICO LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2014-02-24",
        "status": "A",
        "authorized_official_last_name": "BUTCHER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "505-828-4923"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47951",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE (RRB)",
            "identifier": "CH4370",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K5006",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE (RRB)",
            "identifier": "CN6728",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Associates of New Mexico",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.