Individual provider Active NPI

Deborah Joyce Sonnenmoser, O.D.

  • Optometrist
  • Ruidoso, NM
National Provider Identifier
1720175375
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
337 Issued in NM
Practice address
159 Mescalero TRL Ste 1
Ruidoso, NM 88345-6089
Phone
(575) 257-5029
Fax
(575) 257-9096
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 337 NM Primary

Addresses

Primary practice location

159 Mescalero TRL Ste 1
Ruidoso, NM 88345-6089

Mailing address

159 Mescalero TRL Ste 1
Ruidoso, NM 88345-6089
Phone (575) 257-5029

Other identifiers 3

IdentifierTypeStateIssuer
E8076MedicaidNM
E9156MedicaidNM
410032284OtherNMRAIL RAOD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20120719000273 NM Practitioner - Optometry 5496864373 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
337NMMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Gutowski & Sonnenmoser Optometrist CurrentSince Feb 2, 1985 Accepting new patients
DRS. Gutowski & Sonnenmoser Optometrist Past Accepting new patients

Locations

159 Mescalero Trl
Ste 1
Ruidoso, NM 88345
Phone (505) 546-1423

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1720175375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 MESCALERO TRL STE 1",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456089",
            "telephone_number": "575-257-5029",
            "fax_number": "575-257-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 MESCALERO TRL STE 1",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456089",
            "telephone_number": "575-257-5029",
            "fax_number": "575-257-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONNENMOSER",
        "first_name": "DEBORAH",
        "middle_name": "JOYCE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E8076",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E9156",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL RAOD MEDICARE",
            "identifier": "410032284",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruidoso, NM

Sources for this page

Verify at the official NPI Registry.