La Fuente Ocular Prosthetics LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

LA FUENTE OCULAR PROSTHETICS LLC

Doing business as

La Fuente Prosthetics

Practice address

1116 N Robinson Ave
Oklahoma City, OK 73103-4918

Phone

(405) 236-2882

Fax

(405) 236-3335

NPI assigned

Jun 28, 2007

Last updated

Apr 2, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brandon Ray La Fuente, OCULARIST

Title

Manager

Phone

(405) 236-2882

Specialties & licenses 4

Addresses

Other identifiers 6

Other names 1

• La Fuente Prosthetics Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1811194368",
    "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": {
        "organization_name": "LA FUENTE OCULAR PROSTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "LA FUENTE",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-236-2882",
        "authorized_official_credential": "OCULARIST"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KMAP",
            "identifier": "100450270B",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100807050A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KMAP",
            "identifier": "100450270A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL",
            "identifier": "348742200",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP BCBS",
            "identifier": "1114193604",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1679520423",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Fuente Prosthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen Suzanne Kyte, PA-C
• L and M Investments LLC (Neuropathy Treatment Clinic of Oklahoma)
• L Dennis Doan, DC, PLLC (Doan Family Chiropractic)
• La Farmacia
• La Fuente Ocular Prosthetics
• La Fuente Prosthetics
• La Fuente Specialty Prosthetics,LLC
• Henry La Fuente, BCO, BADO
• Monique La Fuente, OCULARIST
• La Luz Organization

• Prosthetic/Orthotic Supplier in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Prosthetic/Orthotic Supplier in Oklahoma

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.