Individual provider Active NPI

Roberto A Molina

  • Optometrist
  • Deming, NM
National Provider Identifier
1962544841
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NM 286 Issued in NM
Practice address
600 E Spruce St
Deming, NM 88030-3857
Phone
(505) 546-4969
Fax
(505) 544-4749
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NM 286 NM Primary

Addresses

Primary practice location

600 E Spruce St
Deming, NM 88030-3857

Mailing address

600 E Spruce St
Deming, NM 88030-3857
Phone (505) 546-4969

Other names 1

  • Dr. Roberto A Molina Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20150317001971 NM Practitioner - Optometry 9335466036 Practice locations: Alamogordo, NM

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NM 286NMMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Intuition Optical PastSince Apr 17, 2022 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962544841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E SPRUCE ST",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880303857",
            "telephone_number": "505-546-4969",
            "fax_number": "505-544-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E SPRUCE ST",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880303857",
            "telephone_number": "505-546-4969",
            "fax_number": "505-544-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA",
        "first_name": "ROBERTO",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "NM 286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERTO",
            "last_name": "MOLINA",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Deming, NM

Sources for this page

Verify at the official NPI Registry.