NPIMap

Organization Active NPI

Eye Associates of New Mexico, LTD.

Doing business as Eye Associates of New Mexico

  • Ophthalmology Physician
  • Roswell, NM
National Provider Identifier
1821413147
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE ASSOCIATES OF NEW MEXICO, LTD.
Doing business as
Eye Associates of New Mexico
Practice address
1606 SE Main St
Roswell, NM 88203-5411
Phone
(575) 624-0370
Fax
(575) 624-0376
NPI assigned
Feb 24, 2014
Last updated
Feb 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Authorized official

Name
Michelle R. Butcher
Title
Credentialing Manager
Phone
(505) 828-4923

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

1606 SE Main St
Roswell, NM 88203-5411

Mailing address

8801 Horizon Blvd NE
Suite 360
Albuquerque, NM 87113-1533
Phone (505) 828-4923

Other identifiers 2

IdentifierTypeStateIssuer
K5006MedicaidNM
47951MedicaidNM

Other names 1

  • Eye Associates of New Mexico Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170110000358 NM DME Supplier - Physician - OphthalmologyDME Supplier - Optician 4486643616 Practice locations: Roswell, NM

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eye Associates of New Mexico1606 SE Main St, Roswell, NM 88203(575) 624-0370 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Fred O Whitehurst MD12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393200000000",
    "number": "1821413147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8801 HORIZON BLVD NE",
            "address_2": "SUITE 360",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131533",
            "telephone_number": "505-828-4923",
            "fax_number": "505-213-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 SE MAIN ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882035411",
            "telephone_number": "575-624-0370",
            "fax_number": "575-624-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE ASSOCIATES OF NEW MEXICO, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-24",
        "last_updated": "2014-02-24",
        "status": "A",
        "authorized_official_last_name": "BUTCHER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "505-828-4923"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K5006",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47951",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Associates of New Mexico",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.