Individual provider Active NPI

Amy L Cruth, O.D.

  • Optometrist
  • Lubbock, TX
National Provider Identifier
1124086970
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
06192TG Issued in TX
Practice address
5713 82ND St
Lubbock, TX 79424-2633
Phone
(806) 798-8820
Fax
(806) 798-9754
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 06192TG TX Primary

Addresses

Primary practice location

5713 82ND St
Lubbock, TX 79424-2633

Mailing address

5713 82ND St
Lubbock, TX 79424-2633
Phone (806) 798-8820

Other identifiers 1

IdentifierTypeStateIssuer
80914QOtherTXBCBSTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040612000290 TX Practitioner - Optometry 4385627900 Reassigns benefits to 1 organization
Practice locations: Amarillo, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Alabama School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Plus LLPGroup PAC ID 4284736307, 5 clinicians

Practice addresses (Care Compare)

5221 S Coulter St
Amarillo, TX 79119-6676
Phone (806) 358-3594

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06192TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Plus LLP Optometrist CurrentSince Jun 1, 2021 Accepting new patients
Lubbock Ophthalmology Associate, P.a. PastSince Nov 1, 2004 Accepting new patients
Kelly J Frasier M.D., P.a. Past Accepting new patients

Locations

5221 S Coulter St
Amarillo, TX 79119
Phone (806) 358-3594

3300 I 40 E
Unit M2
Amarillo, TX 79103

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1124086970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5713 82ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242633",
            "telephone_number": "806-798-8820",
            "fax_number": "806-798-9754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5713 82ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242633",
            "telephone_number": "806-798-8820",
            "fax_number": "806-798-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUTH",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "06192TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "80914Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.