Individual provider Active NPI

Raymond P Herrera, O.D.

  • Optometrist
  • Farmington, NM
National Provider Identifier
1134132228
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
437 Issued in NM
Practice address
113 W Broadway
Farmington, NM 87401-6419
Phone
(505) 326-2020
Fax
(505) 327-5530
NPI assigned
Aug 13, 2006
Last updated
Oct 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 437 NM Primary

Addresses

Primary practice location

113 W Broadway
Farmington, NM 87401-6419

Mailing address

113 W Broadway
Farmington, NM 87401-6419
Phone (505) 326-2020

Other identifiers 1

IdentifierTypeStateIssuer
P2124MedicaidNM

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131102000152 NM Practitioner - Optometry 5991815243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Classic Eyewear, IncGroup PAC ID 7113047564, 2 clinicians

Practice addresses (Care Compare)

113 W Broadway
Farmington, NM 87401-6419
Phone (505) 326-2020

520 E Main
Vision Mart
Farmington, NM 87401-6419
Phone (505) 325-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
437NMMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Classic Eyewear, Inc Optometrist CurrentSince Sep 1, 1994 Accepting new patients

Locations

113 W Broadway
Farmington, NM 87401
Phone (505) 326-2020

520 E Main St
Farmington, NM 87401
Phone (505) 325-2020

Interoperability endpoints

  • Direct secure messaging: raymondbherrera@classiceyewear.direct.eyemdemr.com

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1134132228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W BROADWAY",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016419",
            "telephone_number": "505-326-2020",
            "fax_number": "505-327-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W BROADWAY",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016419",
            "telephone_number": "505-326-2020",
            "fax_number": "505-327-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "RAYMOND",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P2124",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.