Individual provider Active NPI

Robert L Dorazio, OD

  • Eyewear Supplier
  • Gallup, NM
National Provider Identifier
1700994944
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
2328 Issued in NM
Practice address
225 Nizhoni Blvd
Gallup, NM 87301
Phone
(505) 863-5747
Fax
(505) 863-5101
NPI assigned
Aug 28, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 2328 NM Primary
Optometrist 152W00000X 2328 NM

Addresses

Primary practice location

225 Nizhoni Blvd
Gallup, NM 87301

Mailing address

225 Nizhoni Blvd
Gallup, NM 87301
Phone (505) 863-5747

Other identifiers 1

IdentifierTypeStateIssuer
P0987MedicaidNM

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

LicenseStateTypeSpecialty
2328NMMDSpeech-Language Pathologist

Organizations & group practices 1

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1700994944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "87301",
            "telephone_number": "505-863-5747",
            "fax_number": "505-863-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "87301",
            "telephone_number": "505-863-5747",
            "fax_number": "505-863-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORAZIO",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NM",
            "license": "2328",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "2328",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P0987",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.