David Richard Vise, OD
Individual provider Active NPI Optometrist · Santa Fe, NM
NPI 1528093622 · NPPES record last updated Aug 13, 2013
Key facts
- NPI
- 1528093622
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OP2411 (NM)
- Practice address
- 3530 Zafarano Dr
Suite C1
Santa Fe, NM 87507-2617 - Phone
- (505) 473-5100
- Fax
- (505) 473-5104
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cedar Crest Vision LLC
Ultimate Eyecare Santa Fe LLC
Practice addresses (Care Compare)
12220 State Hwy 14 N
Suite 3
Cedar Crest, NM 87008-9407
Phone (505) 286-0300
1651 Galisteo St
Suite 1
Santa Fe, NM 87505-4752
Phone (505) 983-7746
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- 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 |
|---|---|---|---|---|
| I20060324000378 | NM | Practitioner - Optometry | 7214945716 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP2411 | NM | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albuquerque Vision Clinic LLC | Optometrist | Current |
Accepting new patients |
| Ultimate Eyecare Santa Fe, LLC | Optometrist | Current |
Accepting new patients |
| Cedar Crest Vision LLC | Optometrist | Current |
Accepting new patients |
| Jay S. Folkman OD PC | Optometrist | Past | Accepting new patients |
Locations
5343 Wyoming Blvd NE
Ste 2
Albuquerque, NM 87109
Phone (505) 332-2020
12220 N Highway 14
Ste 3
Cedar Crest, NM 87008
Phone (505) 286-0300
1651 Galisteo St
Ste 1A
Santa Fe, NM 87505
Phone (505) 983-7746
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OP2411 | NM | Yes |
Addresses
Primary practice location
3530 Zafarano Dr
Suite C1
Santa Fe, NM 87507-2617
Mailing address
3530 Zafarano Dr
Suite C1
Santa Fe, NM 87507-2617
Phone (505) 473-5100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| J9146 | Medicaid | NM |
Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2013. 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.