Maria G Ceballos, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

04956TG Issued in TX

Practice address

4702 E University Blvd
Odessa, TX 79762-8105

Phone

(432) 550-4245

Fax

(432) 550-4370

NPI assigned

Dec 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University Alabama Birmingham - School of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Odessa Advanced Eye Care PAGroup PAC ID 1355357302, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Odessa Advanced Eye Care, PA

  • Corneal and Contact Management Optometrist
  • Odessa, TX
  • NPI 1972721785
  Medicare reassignment Care Compare group
• Ingram Investments LLC

  • Ophthalmology Physician
  • Midland, TX
  • NPI 1265511463
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1336217504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 E UNIVERSITY BLVD",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797628105",
            "telephone_number": "432-550-4245",
            "fax_number": "432-550-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4702 E UNIVERSITY BLVD",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797628105",
            "telephone_number": "432-550-4245",
            "fax_number": "432-550-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEBALLOS",
        "first_name": "MARIA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "04956TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019389802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "81499Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manuel Castillo, M.D
• Castillorx, LLC
• Irene C Cawi, NURSE PRACTITIONER
• Guillermo Nicolas Cazares, MD
• Suzanne Cearley, CPCP-PC
• Ralph Cepero, M.D.
• Certified CC Opticians
• Monica Cervantes, DPM
• Kalyan Chakrala, D.O.
• John J Challapalli, MD

• Optometrist in Odessa, TX
• Providers in Odessa, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.
• 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.