Cedar Crest Vision LLC

Organization Active NPI Optometrist · Cedar Crest, NM

NPI 1215019237 · NPPES record last updated Jan 14, 2026

Key facts

NPI
1215019237
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
CEDAR CREST VISION LLC
Practice address
12220 North Highway 14
Suite 3
Cedar Crest, NM 87008
Phone
(505) 286-0300
Fax
(505) 281-4765
NPI assigned
Oct 19, 2006
Organization subpart
No

Authorized official

Name
Lisa Quick, MBA, ABOC
Title
Business Manager/Co-Owner
Phone
(505) 980-8972

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070413000380 NM Part B Supplier - Clinic/Group Practice 7810092251 Receives reassigned benefits from 5 practitioners
Practice locations: Cedar Crest, NM

National Provider Directory

Locations

12220 N Highway 14
Ste 3
Cedar Crest, NM 87008
Phone (505) 286-0300

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X Yes

Addresses

Primary practice location

12220 North Highway 14
Suite 3
Cedar Crest, NM 87008

Mailing address

PO Box 1640
Cedar Crest, NM 87008-1640
Phone (505) 286-0300

Other identifiers

IdentifierTypeStateIssuer
65109333MedicaidNM

Other providers in Cedar Crest, NM

All providers in Cedar Crest, NM · Optometrist in New Mexico

Sources for this page

Verify at the official NPI Registry.