Ryan Holiday, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-2023-0001 Issued in NM

Practice address

1 Sagebrush St SW
Albuquerque, NM 87105-3942

Phone

(505) 869-4080

NPI assigned

Jul 14, 2022

Last updated

Feb 27, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, NM2 enrollments

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 2

Specialty

Optometry

Education

Southern College of Optometry, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pueblo of IsletaGroup PAC ID 9739080631, 13 clinicians

Albuquerque Indian Health CenterGroup PAC ID 7719883164, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pueblo of Isleta

  dba Isleta Health Center

  • Clinic/Center
  • Isleta, NM
  • NPI 1194738328
  Medicare reassignment Care Compare group NPD
• Albuquerque Indian Health Center

  • Clinic/Center
  • Albuquerque, NM
  • NPI 1659458917

  TX

  Medicare reassignment Care Compare group
• DHHS,PHS,Naihs, Gallup Indian Medical Center

  • General Acute Care Hospital
  • Gallup, NM
  • NPI 1225002322

  TX

  Medicare reassignment NPD
• Santa Ana Health Center

  • Health Service Clinic/Center
  • Bernalillo, NM
  • NPI 1649331323

  TX

  Medicare reassignment
• DHHS, PHS, Naihs, Gallup Indian Medical Center

  dba Tohatchi Health Center

  • Federal Public Health Clinic/Center
  • Tohatchi, NM
  • NPI 1902875594
  NPD
• Pueblo of Isleta

  dba Pueblo of Isleta Dental Clinic

  • Public Health Dentistry
  • Isleta, NM
  • NPI 1225158348
  NPD
• Pueblo of Isleta

  dba Pueblof of Isleta EMS

  • Ambulance
  • Isleta, NM
  • NPI 1023191368
  NPD (past)
• Pueblo of Isleta

  dba Pueblo of Isleta Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Isleta, NM
  • NPI 1407979008
  NPD (past)

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1720712854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAGEBRUSH ST SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871053942",
            "telephone_number": "505-869-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAGEBRUSH ST SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871053942",
            "telephone_number": "505-869-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLIDAY",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-14",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003825",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "12844144-9934",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "OPT-2023-0001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Holguin, MD
• Saul I Holguin, DO
• Kalina Holian, MT
• Brittany Holiday
• Porter Holiday, LCSW
• Holistic Midwifery
• Holistic Pelvic Health
• Jeri Hollan
• Wendy Coleen Holland Hammer, CHW
• Jeffrey Holland, LCSW

• Optometrist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Optometrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.