Active NPI
Philip E Stein, OD
- Optometrist
- Acoma, NM
National Provider Identifier
1669536918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT-000225
- Practice address
- 80 B Veterans Blvd
Acoma, NM 87034-8703 - Phone
- (505) 552-5300
- Fax
- (505) 552-5490
- NPI assigned
- Dec 21, 2006
- Last updated
- Sep 29, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 | OPT-000225 | AZ | Primary |
Addresses
Primary practice location
80 B Veterans Blvd
Acoma, NM 87034-8703
Mailing address
P.O. Box 130
San Fidel, NM 87049-0130
Phone (505) 552-5379
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H3451 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Navajo Health Foundation-Sage Memorial Hospital, Inc. | Current | Accepting new patients | |
| Navajo Health Foundation-Sage Memorial Hospital Inc | Current | Accepting new patients | |
| U S Health Dept of Health & Human Services | Current | Accepting new patients | |
| Haaku Health | Current | Accepting new patients | |
| US Health Dept of Health & Human Services | Current | Accepting new patients | |
| Tom Sowash OD & Associates PC | Optometrist | Past | Accepting new patients |
| Visionworks Inc | Past | Accepting new patients |
Locations
669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100
Organizations & group practices 7
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 Sage Memorial Physicians
- Rural Acute Care Hospital
- Ganado, AZ
- NPI 1477735777
-
dba Sage Memorial Hospital
- Critical Access Hospital Clinic/Center
- Ganado, AZ
- NPI 1518957398
-
dba Lodge Grass Clinic
- Critical Access Hospital
- Lodge Grass, MT
- NPI 1750410395
-
- Rural Health Clinic/Center
- Poplar, MT
- NPI 1972694602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664409600000",
"number": "1669536918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 130",
"city": "SAN FIDEL",
"state": "NM",
"postal_code": "870490130",
"telephone_number": "505-552-5379",
"fax_number": "505-552-5490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 B VETERANS BLVD",
"city": "ACOMA",
"state": "NM",
"postal_code": "870348703",
"telephone_number": "505-552-5300",
"fax_number": "505-552-5490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEIN",
"first_name": "PHILIP",
"middle_name": "E",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-21",
"last_updated": "2022-09-29",
"certification_date": "2022-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "OPT-000225",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "H3451",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Acoma, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.