Individual provider Active NPI

Paul L Proffer, M.D.

  • Ophthalmology Physician
  • Amarillo, TX
National Provider Identifier
1962488676
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
K3932 Issued in TX
Practice address
1611 Wallace Blvd
Amarillo, TX 79106-1799
Phone
(806) 354-4900
Fax
(806) 352-4987
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X K3932 TX Primary

Addresses

Primary practice location

1611 Wallace Blvd
Amarillo, TX 79106-1799

Mailing address

1611 Wallace Blvd
Amarillo, TX 79106-1799
Phone (806) 354-4900

Other identifiers 1

IdentifierTypeStateIssuer
105845503MedicaidTX

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061005000052 TX Practitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 7113904814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Plastic and Reconstructive Surgery
Education
Texas Tech University Health Science Center School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proffer Surgical Associates, LLPGroup PAC ID 3678579232, 5 clinicians

Practice addresses (Care Compare)

1611 Wallace Blvd
Amarillo, TX 79106-1775
Phone 8063544900414

1611 Wallace Blvd
Amarillo, TX 79106-1799

Merit-based Incentive Payment System (MIPS)

Final score
87.35 of 100Reported as group
Quality
94.17
Promoting interoperability
94
Improvement activities
40
Cost
68.66

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision26
Removal of skin lesions596
Removal or shaving of skin growth1-10
Skin biopsy156

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K3932TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proffer Surgical Associates, LLP Ophthalmology CurrentSince Jul 1, 2006 Accepting new patients
Ophthalmic Surgeons & Consultants of Ohio Inc Ophthalmology Past Accepting new patients
Ohio State University Hospitals Past Accepting new patients
Osu Eye Physicians and Surgeons LLC Ophthalmology PastSince Sep 1, 2017 Accepting new patients

Locations

1611 Wallace Blvd
Amarillo, TX 79106
Phone (806) 352-1185

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AGBCAA

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389139200000",
    "number": "1962488676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061799",
            "telephone_number": "806-354-4900",
            "fax_number": "806-352-4987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061799",
            "telephone_number": "806-354-4900",
            "fax_number": "806-352-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFFER",
        "first_name": "PAUL",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2014-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "K3932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105845503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.