Crystal Gayle Gueldner, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1666-700T Issued in LA

Practice address

139 W Oak St
Ponchatoula, LA 70454-3328

Phone

(985) 467-1223

Fax

(985) 467-0979

NPI assigned

Aug 8, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Crystal Gayle Longoria Former name

Medicare fee-for-service enrollment

Enrolled in LA

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 1

Specialty

Optometry

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: crystalgueldner@shonda-achord.direct.kno2fy.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Crystal Clear Eyecare, LLC

  • Optometrist
  • Ponchatoula, LA
  • NPI 1790150225
  Medicare reassignment NPD Authorized official
• Achord Eye Clinic LLC

  • Optometrist
  • Baton Rouge, LA
  • NPI 1184942401
  Medicare reassignment NPD
• Achord Eye Clinic

  • Eyewear Supplier
  • Baton Rouge, LA
  • NPI 1831261122
  NPD

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1700218054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2128",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704542128",
            "telephone_number": "361-649-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 W OAK ST",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704543328",
            "telephone_number": "985-467-1223",
            "fax_number": "985-467-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUELDNER",
        "first_name": "CRYSTAL",
        "middle_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1666-700T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "LONGORIA",
            "middle_name": "GAYLE",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Optometrist in Ponchatoula, LA
• Providers in Ponchatoula, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.