Individual provider Active NPI

Lauren M Roverse, OD

  • Optometrist
  • Rio Rancho, NM
National Provider Identifier
1659924207
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT2711 Issued in NM
Practice address
4025 Jackie Rd SE
Rio Rancho, NM 87124-6610
Phone
(505) 892-8411
Fax
(505) 891-5497
NPI assigned
Jul 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT2711 NM Primary

Addresses

Primary practice location

4025 Jackie Rd SE
Rio Rancho, NM 87124-6610

Mailing address

4025 Jackie Rd SE
Rio Rancho, NM 87124-6610
Phone (505) 892-8411

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
I20190821004729 NM Practitioner - Optometry 2264760776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Vision Optometry, PCGroup PAC ID 6204168438, 3 clinicians

Practice addresses (Care Compare)

4025 Jackie Rd SE
Rio Rancho, NM 87124-6610
Phone 50589284111104

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT2711NMMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
City of Vision Optometry, PC Optometrist CurrentSince Oct 1, 2019 Accepting new patients

Locations

4025 Jackie Rd SE
Rio Rancho, NM 87124
Phone (505) 892-8411

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1659924207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 JACKIE RD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246610",
            "telephone_number": "505-892-8411",
            "fax_number": "505-375-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 JACKIE RD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246610",
            "telephone_number": "505-892-8411",
            "fax_number": "505-891-5497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROVERSE",
        "first_name": "LAUREN",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "OPT2711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

Verify at the official NPI Registry.