Individual provider Active NPI

Luisa Rahell Alvarez, O.D.

  • Optometrist
  • Fort Defiance, AZ
National Provider Identifier
1255461174
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2528 Issued in CO
Practice address
Corner of Route N12 and N7
Fort Defiance Hospital Board, Inc.
Fort Defiance, AZ 86504
Phone
(951) 312-9596
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 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 2528 CO Primary

Addresses

Primary practice location

Corner of Route N12 and N7
Fort Defiance Hospital Board, Inc.
Fort Defiance, AZ 86504

Mailing address

PO Box 649
Fort Defiance Indian Hospital Board, Inc.
Fort Defiance, AZ 86504-0649
Phone (951) 312-9596

Other identifiers 1

IdentifierTypeStateIssuer
88350274MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2528COMDOptometrist
585NMMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS PHS Naihs Fort Defiance Hospital 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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1255461174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "address_2": "FORT DEFIANCE INDIAN HOSPITAL BOARD, INC.",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "951-312-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "address_2": "FORT DEFIANCE HOSPITAL BOARD, INC.",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "951-312-9596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ",
        "first_name": "LUISA",
        "middle_name": "RAHELL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88350274",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Defiance, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.