Individual provider Active NPI

Anjali Nicole Paramanandam, OD

  • Optometrist
  • Shiprock, NM
National Provider Identifier
1194401745
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003931 Issued in CO
Practice address
US-491
Shiprock, NM 87420
Phone
(505) 368-6001
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.0003931 CO Primary

Addresses

Primary practice location

US-491
Shiprock, NM 87420

Mailing address

210 Via Hacienda
Newbury Park, CA 91320-6836
Phone (805) 410-2752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX2 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

Enrollment IDStateProvider typePAC IDDetails
I20231221002604 CO Practitioner - Optometry 8729438486 Reassigns benefits to 1 organization
I20240816002227 TX Practitioner - Optometry 8729438486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Eyecare PLLCGroup PAC ID 7012315104, 3 clinicians
DHHS PHS Naihs Shiprock HospitalGroup PAC ID 0749193837, 148 clinicians

Practice addresses (Care Compare)

3710 Main Ave
Suite 203
Durango, CO 81301-4033
Phone (970) 403-5655

Highway 491
Shiprock, NM 87420-0160
Phone 50536860016401

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
74.27
Improvement activities
40
Cost
78.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.0003931COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Eyecare PLLC Optometrist CurrentSince Dec 8, 2023 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Jun 1, 2024 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Jun 1, 2024 Accepting new patients

Locations

3710 Main Ave
Ste 203
Durango, CO 81301
Phone (970) 403-5655

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1194401745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 VIA HACIENDA",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913206836",
            "telephone_number": "805-410-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US-491",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "87420",
            "telephone_number": "505-368-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARAMANANDAM",
        "first_name": "ANJALI",
        "middle_name": "NICOLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiprock, NM

Sources for this page

Verify at the official NPI Registry.