Individual provider Active NPI

Philip E Stein, OD

  • Optometrist
  • Acoma, NM
National Provider Identifier
1669536918
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-000225 Issued in AZ
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, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
H3451MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050725000477 AZ Practitioner - Optometry 3577590223 Reassigns benefits to 1 organization
I20150428000464 TX Practitioner - Optometry 3577590223 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Navajo Health Foundation-Sage Memorial Hospital, Inc. CurrentSince Sep 15, 2021 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital Inc CurrentSince Sep 15, 2021 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Apr 2, 2015 Accepting new patients
Haaku Health CurrentSince Oct 24, 2025 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.

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

Verify at the official NPI Registry.