Individual provider Active NPI

Michael T Reeder Jr., O.D.

  • Optometrist
  • Fruita, CO
National Provider Identifier
1003175878
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2916 Issued in CO
Practice address
332 E Aspen Ave
Ste 100
Fruita, CO 81521-2204
Phone
(970) 858-2020
Fax
(970) 858-6601
NPI assigned
May 14, 2012
Last updated
Mar 3, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2916 CO Primary

Addresses

Primary practice location

332 E Aspen Ave
Ste 100
Fruita, CO 81521-2204

Mailing address

332 E Aspen Ave
Ste 100
Fruita, CO 81521-2204
Phone (970) 858-2020

Other identifiers 1

IdentifierTypeStateIssuer
10559078MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20120726000173 CO Practitioner - Optometry 2466618053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visualeyes Eye Care PCGroup PAC ID 8729079157, 3 clinicians

Practice addresses (Care Compare)

332 E Aspen Ave
Suite 100
Fruita, CO 81521-2204
Phone (970) 858-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2916COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visualeyes Eyecare, P.C. Optometrist CurrentSince Jun 1, 2012 Accepting new patients
Dr Thomas Politzer OD PC Optometrist Past Accepting new patients

Organizations & group practices 2

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": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1003175878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 E ASPEN AVE",
            "address_2": "STE 100",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815212204",
            "telephone_number": "970-858-2020",
            "fax_number": "970-858-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 E ASPEN AVE",
            "address_2": "STE 100",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815212204",
            "telephone_number": "970-858-2020",
            "fax_number": "970-858-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDER",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-14",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10559078",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruita, CO

Sources for this page

Verify at the official NPI Registry.