Active NPI
Sean Carlile, O.D.
- Optometrist
- Albuquerque, NM
National Provider Identifier
1104133420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 623
- Practice address
- 1646 Alameda Blvd NW
Albuquerque, NM 87114-8807 - Phone
- (505) 792-3937
- Fax
- (505) 792-3501
- NPI assigned
- Sep 8, 2010
- Last updated
- Sep 8, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 623 | NM | Primary |
Addresses
Primary practice location
1646 Alameda Blvd NW
Albuquerque, NM 87114-8807
Mailing address
12400 Montgomery Blvd NE Apt 32
Albuquerque, NM 87111-4164
Phone (505) 999-7234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1646 Alameda Blvd NW
Albuquerque, NM 87114-8807
Phone (505) 452-2020
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 623 | NM | MD | Peer Specialist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283904000000",
"number": "1104133420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12400 MONTGOMERY BLVD NE APT 32",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871114164",
"telephone_number": "505-999-7234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1646 ALAMEDA BLVD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871148807",
"telephone_number": "505-792-3937",
"fax_number": "505-792-3501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLILE",
"first_name": "SEAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-08",
"last_updated": "2010-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NM",
"license": "623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.