Individual provider Active NPI

Ronaldo Esau Leon, OD

  • Optometrist
  • Amarillo, TX
National Provider Identifier
1124619440
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10272T Issued in TX
Practice address
5221 S Coulter St
Amarillo, TX 79119-6676
Phone
(806) 358-3594
NPI assigned
Jan 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10272T TX Primary

Addresses

Primary practice location

5221 S Coulter St
Amarillo, TX 79119-6676

Mailing address

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

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
I20211116003207 TX Practitioner - Optometry 1052700820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2021
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
10272TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Plus LLP Optometrist CurrentSince Aug 12, 2021 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 1

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": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124619440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791196676",
            "telephone_number": "806-358-3594",
            "fax_number": "806-457-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5221 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791196676",
            "telephone_number": "806-358-3594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "RONALDO",
        "middle_name": "ESAU",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-29",
        "last_updated": "2022-07-21",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10272T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.