Individual provider Active NPI

Mansur Nurdel, O.D.

  • Optometrist
  • Highlands Ranch, CO
National Provider Identifier
1023166204
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1910 Issued in CO
Practice address
3622 E Highlands Ranch Pkwy
Suite 101
Highlands Ranch, CO 80126-8100
Phone
(303) 683-4466
Fax
(303) 683-4467
NPI assigned
Jan 6, 2007
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1910 CO Primary

Addresses

Primary practice location

3622 E Highlands Ranch Pkwy
Suite 101
Highlands Ranch, CO 80126-8100

Mailing address

3622 E Highlands Ranch Pkwy
Suite 101
Highlands Ranch, CO 80126-8100
Phone (303) 683-4466

Other identifiers 1

IdentifierTypeStateIssuer
34633839MedicaidCO

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
I20101101001189 CO Practitioner - Optometry 5991784381 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Look Optical PCGroup PAC ID 2668451055, 10 clinicians
Eye to Eye Care, P.C.Group PAC ID 5294984092, 5 clinicians

Practice addresses (Care Compare)

3130 S Parker Rd
Aurora, CO 80014-3110
Phone (303) 752-2662

9225 S Broadway
Highlands Ranch, CO 80129-5651
Phone (303) 683-4466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1910COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye to Eye Care, PC Optometrist CurrentSince Aug 28, 2012 Accepting new patients
Oneopto Co 1 PLLC Optometrist PastSince Nov 16, 2023 Accepting new patients
Oneopto Co 1 PLLC Optometrist PastSince Aug 28, 2012 Accepting new patients
Advanced Eyecare Durango, PLLC Optometrist PastSince Jan 1, 2024 Accepting new patients

Locations

9225 S Broadway
Highlands Ranch, CO 80129
Phone (303) 683-4466

9225 S Broadway
Ste A
Highlands Ranch, CO 80129
Phone (303) 683-4466

Organizations & group practices 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1023166204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3622 E HIGHLANDS RANCH PKWY",
            "address_2": "SUITE 101",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801268100",
            "telephone_number": "303-683-4466",
            "fax_number": "303-683-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 E HIGHLANDS RANCH PKWY",
            "address_2": "SUITE 101",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801268100",
            "telephone_number": "303-683-4466",
            "fax_number": "303-683-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NURDEL",
        "first_name": "MANSUR",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34633839",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

Verify at the official NPI Registry.