Individual provider Active NPI

Seth Taylor

  • Optometrist
  • Albuquerque, NM
National Provider Identifier
1518292697
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
640 Issued in NM
Practice address
9935 Coors Byp NW Ste B
Albuquerque, NM 87114-6195
Phone
(505) 899-8993
Fax
(505) 898-8994
NPI assigned
Oct 7, 2009
Last updated
Oct 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Optometrist 152W00000X 640 NM Primary

Addresses

Primary practice location

9935 Coors Byp NW Ste B
Albuquerque, NM 87114-6195

Mailing address

1111 Birch St
Forest Grove, OR 97116-2946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20180201003011 NM Practitioner - Optometry 9537429097 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
640NMMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Idoc, Inc Optometrist CurrentSince Oct 1, 2021 Accepting new patients
Taylor Family Eyecare LLC Optometrist CurrentSince Dec 3, 2024 Accepting new patients
Blue Whale, Inc. Optometrist Current Accepting new patients

Locations

8201 Golf Course Rd NW
Ste C4
Albuquerque, NM 87120
Phone (505) 899-8993

9935 Coors Bypass NW
Ste B
Albuquerque, NM 87114
Phone (505) 899-8993

3811 Cerrillos Rd
Ste 103
Santa Fe, NM 87507
Phone (505) 989-9600

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1518292697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BIRCH ST",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9935 COORS BYP NW STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871146195",
            "telephone_number": "505-899-8993",
            "fax_number": "505-898-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "SETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-07",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.