Albuquerque Eye Prosthetics Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ALBUQUERQUE EYE PROSTHETICS INC

Practice address

4117 Montgomery Blvd NE
Albuquerque, NM 87109-1102

Phone

(505) 884-2927

Fax

(505) 884-2672

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Roy Dale McDonnell, B.C.ONPI 1063513992

Title

President

Phone

(505) 884-2927

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Roy Dale McDonnell, B.C.O.

  • Specialist
  • Albuquerque, NM
  • NPI 1063513992
  NPD Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285723650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091102",
            "telephone_number": "505-884-2927",
            "fax_number": "505-884-2672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091102",
            "telephone_number": "505-884-2927",
            "fax_number": "505-884-2672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBUQUERQUE EYE PROSTHETICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCDONNELL",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-884-2927",
        "authorized_official_credential": "B.C.O"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T2326",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Durable Medical Equipment & Medical Supplies in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.