Individual provider Active NPI

Adaly R Ramos, OD

  • Optometrist
  • Odessa, TX
National Provider Identifier
1841894698
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10021 Issued in TX
Practice address
3863 E 42ND St
Odessa, TX 79762-5947
Phone
(432) 363-9974
NPI assigned
Nov 23, 2020
Last updated
Nov 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10021 TX Primary

Addresses

Primary practice location

3863 E 42ND St
Odessa, TX 79762-5947

Mailing address

3540 N Canterbury Ave
Odessa, TX 79764-1052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230621002868 TX Practitioner - Optometry 6800254962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Odessa Vision Center, PLLCGroup PAC ID 0648341446, 3 clinicians

Practice addresses (Care Compare)

4015 Penbrook St
Odessa, TX 79762-5917
Phone (432) 362-3133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10021TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Odessa Vision Center PLLC Optometrist CurrentSince Jun 20, 2023 Accepting new patients

Locations

4015 Penbrook St
Odessa, TX 79762
Phone (432) 361-3133

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": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1841894698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 N CANTERBURY AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797641052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3863 E 42ND ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625947",
            "telephone_number": "432-363-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS",
        "first_name": "ADALY",
        "middle_name": "R",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.