Active NPI
Anthony Paul Stout, O.D.
- Optometrist
- Albuquerque, NM
National Provider Identifier
1306816343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5670092-9934
- Practice address
- Albuquerque Indian Health Center- Optometry Clinic
801 Vassar Dr. N.E.
Albuquerque, NM 87106 - Phone
- (505) 248-4037
- Fax
- (505) 248-7721
- NPI assigned
- Jan 24, 2006
- Last updated
- Feb 23, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5670092-9934 | UT | Primary |
Addresses
Primary practice location
Albuquerque Indian Health Center- Optometry Clinic
801 Vassar Dr. N.E.
Albuquerque, NM 87106
Mailing address
801 Vassar Dr NE
Optometry Clinic
Albuquerque, NM 87106-2725
Phone (505) 508-8553
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albuquerque Indian Health Center | Current | Accepting new patients | |
| Pueblo of Isleta | Past | Accepting new patients | |
| Pueblo of Isleta | Past | Accepting new patients |
Locations
801 Vassar Dr NE
Albuquerque, NM 87106
Phone (505) 248-4000
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Pueblo of Isleta Pharmacy
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Isleta, NM
- NPI 1407979008
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424649600000",
"number": "1306816343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 VASSAR DR NE",
"address_2": "OPTOMETRY CLINIC",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871062725",
"telephone_number": "505-508-8553",
"fax_number": "505-248-7721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ALBUQUERQUE INDIAN HEALTH CENTER- OPTOMETRY CLINIC",
"address_2": "801 VASSAR DR. N.E.",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87106",
"telephone_number": "505-248-4037",
"fax_number": "505-248-7721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOUT",
"first_name": "ANTHONY",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-24",
"last_updated": "2015-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "UT",
"license": "5670092-9934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.