Individual provider Active NPI

Ronald F De la Fuente, O.D.

  • Optometrist
  • Allen, TX
National Provider Identifier
1922072750
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5936TG Issued in TX
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.

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20041124000034 TX Practitioner - Optometry 5092770503 Practice locations: Plano, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5936TXMDChiropractor
5936TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Vision Clinic Optometrist CurrentSince Sep 27, 2020 Accepting new patients

Locations

2400 K Ave
Ste 2400E
Plano, TX 75074
Phone (972) 424-7236

Interoperability endpoints

  • Direct secure messaging: ronald.de.la.fuente.1@17949.direct.athenahealth.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5936TG TX Primary

Addresses

NPPES NPI Registry

Primary 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
IdentifierTypeStateIssuer
176230401MedicaidTX

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

Verify at the official NPI Registry.