NPIMap

Organization Active NPI

Eye Associates of New Mexico, LTD.

Doing business as Eye Associates of New Mexico

  • Durable Medical Equipment & Medical Supplies
  • Los Alamos, NM
National Provider Identifier
1104963040
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
EYE ASSOCIATES OF NEW MEXICO, LTD.
Doing business as
Eye Associates of New Mexico
Practice address
1623 Central Ave
Los Alamos, NM 87544-3018
Phone
(505) 662-5444
Fax
(505) 662-6109
NPI assigned
Jan 31, 2007
Last updated
Dec 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Authorized official

Name
Amber Kristin Terry
Title
Credentialing Coordinator
Phone
(505) 246-2622

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary
Optometrist 152W00000X NU
Optician 156FX1800X NU
Ophthalmology Physician 207W00000X NU

Addresses

Primary practice location

1623 Central Ave
Los Alamos, NM 87544-3018

Mailing address

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

Other identifiers 4

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

Other names 1

  • Eye Associates of New Mexico Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930070032 NM DME Supplier - Physician - OphthalmologyDME Supplier - OpticianDME Supplier - Physician - Optometrist 4486643616 Practice locations: Los Alamos, NM

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eye Associates of New Mexico1623 Central Ave, Los Alamos, NM 87544-3018(505) 662-5444 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Fred O Whitehurst MD12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

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

Practitioners & affiliated clinicians

Practitioners 60

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 60

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": "1734652800000",
    "number": "1104963040",
    "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": "1623 CENTRAL AVE",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875443018",
            "telephone_number": "505-662-5444",
            "fax_number": "505-662-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES OF NEW MEXICO, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "KRISTIN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "505-246-2622"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K5006",
            "state": "NM"
        },
        {
            "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": "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 Los Alamos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.