NPIMap

Organization Active NPI

Optometrics PC

  • Corneal and Contact Management Optometrist
  • Espanola, NM
National Provider Identifier
1679011191
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
NM307 Issued in NM
Legal business name
OPTOMETRICS PC
Practice address
612 N Paseo de Onate
Espanola, NM 87532-2963
Phone
(505) 753-7355
Fax
(505) 753-7533
NPI assigned
Feb 3, 2017
Last updated
Feb 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Authorized official

Name
Dr. Michael H Meneakis, ODNPI 1093722894
Title
Owner
Phone
(505) 753-7355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X NM307 NM Primary

Addresses

Primary practice location

612 N Paseo de Onate
Espanola, NM 87532-2963

Mailing address

612 N Paseo de Onate
Espanola, NM 87532-2963
Phone (505) 753-7355

Other identifiers 2

IdentifierTypeStateIssuer
M50784552MedicaidNM
50784552MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
DRS McCloskey and Meneakis2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

612 N Paseo de Onate
Espanola, NM 87532
Phone (505) 753-2203

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486080000000",
    "number": "1679011191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 N PASEO DE ONATE",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322963",
            "telephone_number": "505-753-7355",
            "fax_number": "505-753-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N PASEO DE ONATE",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322963",
            "telephone_number": "505-753-7355",
            "fax_number": "505-753-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-03",
        "last_updated": "2017-02-03",
        "status": "A",
        "authorized_official_last_name": "MENEAKIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-753-7355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NM",
            "license": "NM307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M50784552",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50784552",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Espanola, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.