Active NPI
Ronald F De la Fuente, O.D.
- Optometrist
- Allen, TX
National Provider Identifier
1922072750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5936TG
- Practice address
- 571 Windsor Dr
Allen, TX 75002-4084 - Phone
- (469) 418-2806
- Fax
- (972) 423-0614
- NPI assigned
- Feb 16, 2006
- Sex
- Male
- Sole proprietor
- No
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 and National Provider Directory roles.
-
- Optometrist
- Plano, TX
- NPI 1780291773
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
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041124000034 | TX | Practitioner - Optometry | 5092770503 | Practice locations: Plano, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5936 | TX | MD | Chiropractor |
| 5936TG | TX | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Vision Clinic | Optometrist | Current | Accepting new patients |
Locations
2400 K Ave
Ste 2400E
Plano, TX 75074
Phone (972) 424-7236
Interoperability endpoints
- ronald.de.la.fuente.1@17949.direct.athenahealth.com
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5936TG | TX | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
571 Windsor Dr
Allen, TX 75002-4084
Mailing address
571 Windsor Dr
Allen, TX 75002-4084
Phone (469) 418-2806
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 176230401 | Medicaid | TX |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 9, 2024.
{
"created_epoch": "1140048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715212800000",
"number": "1922072750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "571 WINDSOR DR",
"city": "ALLEN",
"state": "TX",
"postal_code": "750024084",
"telephone_number": "469-418-2806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "571 WINDSOR DR",
"city": "ALLEN",
"state": "TX",
"postal_code": "750024084",
"telephone_number": "469-418-2806",
"fax_number": "972-423-0614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA FUENTE",
"first_name": "RONALD",
"middle_name": "F",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-16",
"last_updated": "2024-05-09",
"certification_date": "2024-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "5936TG",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "176230401",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Allen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.