NPIMap

Organization Active NPI

Donald B. Leach, O.D., P.C.

  • Optometrist
  • Los Lunas, NM
National Provider Identifier
1073784351
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
245/OP2245 Issued in NM
Legal business name
DONALD B. LEACH, O.D., P.C.
Practice address
943 Main Street SW
Los Lunas, NM 87031-8748
Phone
(505) 865-4812
Fax
(505) 865-3767
NPI assigned
Mar 14, 2008
Last updated
Oct 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Authorized official

Name
Dr. Donald B Leach, O.D.NPI 1578561312
Title
President/Doctor
Phone
(505) 865-4812

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 245/OP2245 NM
Optometrist 152W00000X 245/OP2245 NM Primary

Addresses

Primary practice location

943 Main Street SW
Los Lunas, NM 87031-8748

Mailing address

943 Main Street SW
Los Lunas, NM 87031-8748
Phone (505) 865-4812

Other identifiers 6

IdentifierTypeStateIssuer
999995614OtherNMVSP
NM00P054OtherNMBLUECROSS BLUESHIELD
NMB2264MedicaidNM
10007839OtherNMLOVELACE HEALTH, SR
201005637OtherNMPRESBYTERIAN HEALTH, SR
826580615OtherNMRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

943 Main St SW
Los Lunas, NM 87031
Phone (505) 865-4812

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1073784351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 MAIN STREET SW",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870318748",
            "telephone_number": "505-865-4812",
            "fax_number": "505-865-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 MAIN STREET SW",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870318748",
            "telephone_number": "505-865-4812",
            "fax_number": "505-865-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD B. LEACH, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/DOCTOR",
        "authorized_official_telephone_number": "505-865-4812",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NM",
            "license": "245/OP2245",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "245/OP2245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "999995614",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "NM00P054",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NMB2264",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE HEALTH, SR",
            "identifier": "10007839",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN  HEALTH, SR",
            "identifier": "201005637",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "826580615",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Lunas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.