Raul Angeles Jr., OD
Individual provider Active NPI Optometrist · Jber, AK
NPI 1285017194 · NPPES record last updated Apr 23, 2020
Key facts
- NPI
- 1285017194
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 0000 (AK)
- Practice address
- 5800 Westover Ave
Jber, AK 99506-1603 - Phone
- (907) 978-1937
- NPI assigned
- Jul 9, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Southcentral Foundation
Practice addresses (Care Compare)
1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083
3445 E Cottle Loop
Wasilla, AK 99654-7263
Phone (907) 206-4143
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.77 of 100
- Quality
- 76.11
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.79
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, AK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150828001296 | TX | Practitioner - Optometry | 7911213418 | Reassigns benefits to 1 organization |
| I20200325002697 | AK | Practitioner - Optometry | 7911213418 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000 | AK | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alaska Native Tribal Health Consortium | Current | Accepting new patients | |
| Southcentral Foundation | Current |
Accepting new patients | |
| Southcentral Foundation | Current | Accepting new patients | |
| Midnight Sun Optometry | Optometrist | Current |
Accepting new patients |
| Southcentral Foundation | Past | Accepting new patients |
Locations
5800 Westover Ave
Jber, AK 99506
Phone (907) 753-7500
1001 S Knik Goose Bay Rd
Wasilla, AK 99654
Phone (907) 631-7800
281 N Main St
Wasilla, AK 99654
Phone (907) 978-1937
3445 E Cottle Loop
Wasilla, AK 99654
Phone (907) 753-7515
Interoperability endpoints
- raul.angeles@uprisedirect.com
- rangeles@direct.scf.cc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0000 | AK | Yes |
Addresses
Primary practice location
5800 Westover Ave
Jber, AK 99506-1603
Mailing address
PO Box 876606
Wasilla, AK 99687-6606
Phone (907) 978-1937
Other practice location 1
5800 Westover Ave
Elmendorf AFB, AK 99506-1603
Phone (907) 753-7515
Other providers in Jber, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.