Individual provider Active NPI

Blake G. Simmons, O.D.

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1003909482
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-2588 Issued in CO
Practice address
320 E Fontanero St Ste 201
Colorado Springs, CO 80907-7525
Phone
(719) 559-2020
Fax
(719) 623-6088
NPI assigned
Sep 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1756 KS
Optometrist 152W00000X OPT-2588 CO Primary

Addresses

Primary practice location

320 E Fontanero St Ste 201
Colorado Springs, CO 80907-7525

Mailing address

320 E Fontanero St Ste 201
Colorado Springs, CO 80907-7525
Phone (719) 559-2020

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
I20070828000989 CO Practitioner - Optometry 4082706536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simmons Eye AssociatesGroup PAC ID 5890915490, 4 clinicians

Practice addresses (Care Compare)

320 E Fontanero St
Suite 201
Colorado Springs, CO 80907-7525
Phone (719) 559-2020

Merit-based Incentive Payment System (MIPS)

Final score
89.52 of 100Reported as individual
Quality
69.04
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-2588COMDOptometrist
1756KSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Simmons Eye Associates Optometrist CurrentSince Aug 1, 2014 Accepting new patients
Simmons Eye Associates Optometrist CurrentSince Aug 1, 2014 Accepting new patients
Eye Specialists of Colorado LLC Optometrist Past Accepting new patients
Colorado Vision Optometrist Past Accepting new patients

Locations

1715 N Weber St
Ste 360
Colorado Springs, CO 80907
Phone (719) 471-4000

320 E Fontanero St
Ste 201
Colorado Springs, CO 80907
Phone (719) 559-2020

5278 N Nevada Ave
Ste 120
Colorado Springs, CO 80918
Phone (719) 559-2020

Networks

  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO D-SNP
  • CO HMO

Interoperability endpoints

  • Direct secure messaging: blake.simmons@corhio.medicity.net

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": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1003909482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E FONTANERO ST STE 201",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077525",
            "telephone_number": "719-559-2020",
            "fax_number": "719-623-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E FONTANERO ST STE 201",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077525",
            "telephone_number": "719-559-2020",
            "fax_number": "719-623-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "BLAKE",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1756",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT-2588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.