Individual provider Active NPI

Kent R Schauer, O.D.

  • Optometrist
  • Albuquerque, NM
National Provider Identifier
1235220179
Registry record updated May 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
221 Issued in NM
Practice address
4101 Morris St NE
Suite a
Albuquerque, NM 87111-3605
Phone
(505) 299-4426
Fax
(505) 299-3746
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 221 NM Primary

Addresses

Primary practice location

4101 Morris St NE
Suite a
Albuquerque, NM 87111-3605

Mailing address

4101 Morris St NE
Suite a
Albuquerque, NM 87111-3605
Phone (505) 299-4426

Other identifiers 2

IdentifierTypeStateIssuer
NM01P518OtherNMBCBS OF NEW MEXICO
P5283MedicaidNM

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
I20120612000360 NM Practitioner - Optometry 9234393869 Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
221NMMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kent Schauer OD PC Past Accepting new patients

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1235220179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 MORRIS ST NE",
            "address_2": "SUITE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113605",
            "telephone_number": "505-299-4426",
            "fax_number": "505-299-3746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 MORRIS ST NE",
            "address_2": "SUITE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113605",
            "telephone_number": "505-299-4426",
            "fax_number": "505-299-3746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAUER",
        "first_name": "KENT",
        "middle_name": "R",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NEW MEXICO",
            "identifier": "NM01P518",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P5283",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.