NPIMap

Organization Active NPI

Elite Vision, P.C.

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1023286804
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2496 Issued in CO
Legal business name
ELITE VISION, P.C.
Practice address
4195 Centennial Blvd
Colorado Springs, CO 80907-3767
Phone
(719) 471-1107
NPI assigned
Feb 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Authorized official

Name
Dr. Leroy Popowski, O.D.NPI 1881673978
Title
Optometrist/President
Phone
(719) 471-1107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2496 CO Primary

Addresses

Primary practice location

4195 Centennial Blvd
Colorado Springs, CO 80907-3767

Mailing address

4195 Centennial Blvd
Colorado Springs, CO 80907-3767
Phone (719) 471-1107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080306000235 CO Part B Supplier - Clinic/Group Practice 1456436021 Receives reassigned benefits from 3 practitioners
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620691200000",
    "number": "1023286804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4195 CENTENNIAL BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073767",
            "telephone_number": "719-471-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4195 CENTENNIAL BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073767",
            "telephone_number": "719-471-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE VISION, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-14",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A",
        "authorized_official_last_name": "POPOWSKI",
        "authorized_official_first_name": "LEROY",
        "authorized_official_title_or_position": "OPTOMETRIST/PRESIDENT",
        "authorized_official_telephone_number": "719-471-1107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.