Alexandra E Gada, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT.0C03484 Issued in CO

Practice address

85 West Highway 22
Santo Domingo, NM 87052-0340

Phone

(505) 465-3060

NPI assigned

Jun 27, 2019

Last updated

Sep 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, NM2 enrollments

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 2

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kewa Pueblo Health CorporationGroup PAC ID 7618137779, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alexandra.gada.p1@direct.kp-hc.nextgenshare.com

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.

• Kewa Pueblo Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Santo Domingo Pueblo, NM
  • NPI 1467739888

  TX

  Medicare reassignment Care Compare group NPD
• Cottonwood Vision Care LLC

  dba Orbit Eyecare

  • Optometrist
  • Albuquerque, NM
  • NPI 1306913462
  Medicare reassignment
• Kewa Pueblo Health Corporation

  • Community/Behavioral Health Agency
  • Santo Domingo Pueblo, NM
  • NPI 1336659077
  NPD (past)

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1124689336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 LARKIN AVE",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417738",
            "telephone_number": "847-693-6554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 WEST HIGHWAY 22",
            "city": "SANTO DOMINGO",
            "state": "NM",
            "postal_code": "870520340",
            "telephone_number": "505-465-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADA",
        "first_name": "ALEXANDRA",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2021-09-10",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "728",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0C03484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Brooks, R.N.
• Jimmie R Charlie, M.D.
• Cynthia Eileen Guzman, PH.D.
• Andrea Heeter, PA-C, ATC
• Kewa Pueblo Health Corporation (Santo Domingo Health Center)
• Kewa Pueblo Health Corporation (Santo Domingo Health Center)
• Kewa Pueblo Health Corporation (Santo Domingo Health Center)

• Optometrist in Santo Domingo, NM
• Providers in Santo Domingo, NM by specialty
• Optometrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.

Verify at the official NPI Registry.