Casey Optical Too
Organization Active NPI Optometrist · Albuquerque, NM
NPI 1669833166 · NPPES record last updated Aug 30, 2022
Key facts
- NPI
- 1669833166
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- CASEY OPTICAL TOO
- Practice address
- 9000 Menaul Blvd NE
Albuquerque, NM 87112-2231 - Phone
- (505) 219-3113
- Fax
- (505) 792-6608
- NPI assigned
- Mar 10, 2016
- Organization subpart
- No
Authorized official
- Name
- Ms. Kimberly Adams Broderick
- Title
- Managing Member
- Phone
- (505) 379-2158
Practitioners 4
-
Drew Casey, OD
-
Christine M Kniffen, O.D.
-
Angela Morgan, O.D.
-
Dustin Dawson, OD, MS
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180511000482 | NM | Part B Supplier - Clinic/Group Practice | 6002170487 |
Receives reassigned benefits from 4 practitioners Practice locations: Albuquerque, NM |
National Provider Directory
Locations
9000 Menaul Blvd NE
Albuquerque, NM 87112
Phone (505) 219-3113
Interoperability endpoints
- co2@casey-optical-nm.direct.consensus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes | ||
| Eyewear Supplier | 332H00000X |
Addresses
Primary practice location
9000 Menaul Blvd NE
Albuquerque, NM 87112-2231
Mailing address
9000 Menaul Blvd NE
Albuquerque, NM 87112-2231
Phone (505) 219-3113
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09703381 | Medicaid | NM |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | CO2@casey-optical-nm.direct.consensus.com | Direct |
Other providers in Albuquerque, NM
- Richard Gene Casaus
- Angelica Gabriela Casavantes
- Joanne Cascio
- Genice Case
- Casey Allman DMD LLC
- Drew Casey
- Hannah Casey
- Mary F Casey
- Paula Denise Casey
- Siri L Casey
All providers in Albuquerque, NM · Optometrist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2022. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.