Active NPI
Henry La Fuente, BCO, BADO
- Ocularist
- Oklahoma City, OK
National Provider Identifier
1679520423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ocularist
- License
- 331034873
- Practice address
- 1116 N Robinson Ave
Oklahoma City, OK 73103-4918 - Phone
- (405) 236-2882
- Fax
- (405) 236-3335
- NPI assigned
- May 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetist | 224P00000X | |||
| Ocularist | 156FX1700X | 331034873 | OK | Primary |
| Orthotic Fitter | 225000000X | 331034873 | OK | |
| Anaplastologist | 229N00000X |
Addresses
Primary practice location
1116 N Robinson Ave
Oklahoma City, OK 73103-4918
Mailing address
1116 N Robinson Ave
Oklahoma City, OK 73103-4918
Phone (405) 236-2882
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 331034873 | Other | OK | TAX ID |
| 1811194368 | Other | OK | GROUP NPI |
| 100807050A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 331034873 | OK | MD | Ocularist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333324800000",
"number": "1679520423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1116 N ROBINSON AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731034918",
"telephone_number": "405-236-2882",
"fax_number": "405-236-3335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1116 N ROBINSON AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731034918",
"telephone_number": "405-236-2882",
"fax_number": "405-236-3335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LA FUENTE",
"first_name": "HENRY",
"name_prefix": "Mr.",
"credential": "BCO, BADO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-27",
"last_updated": "2012-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": null,
"license": null,
"primary": false
},
{
"code": "156FX1700X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Ocularist",
"state": "OK",
"license": "331034873",
"primary": true
},
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": "OK",
"license": "331034873",
"primary": false
},
{
"code": "229N00000X",
"taxonomy_group": "",
"desc": "Anaplastologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "331034873",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1811194368",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100807050A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.