Individual provider Active NPI

Lorena Delagarza, O.D.

  • Optometrist
  • Fort Collins, CO
National Provider Identifier
1043523129
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0003281 Issued in CO
Practice address
3100 S College Ave
Suite 120
Fort Collins, CO 80525-2643
Phone
(970) 223-5030
Fax
(970) 223-5884
NPI assigned
Jul 19, 2010
Last updated
Mar 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 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 0003281 CO Primary
Optometrist 152W00000X 7346TG TX

Addresses

Primary practice location

3100 S College Ave
Suite 120
Fort Collins, CO 80525-2643

Mailing address

3100 South College Ave
Suite 120
Fort Collins, CO 80525-2654
Phone (970) 223-5030

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
I20170523000404 CO Practitioner - Optometry 4688857667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3100 S College Ave
Suite 120
Fort Collins, CO 80525-2654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0003281COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Creek Eye Care, PLLC Optometrist CurrentSince Apr 4, 2017 Accepting new patients
Jonadia, Inc. Optometrist PastSince Apr 5, 2020 Accepting new patients
William Justus Head MD PA Past Accepting new patients

Locations

3100 S College Ave
Ste 120
Fort Collins, CO 80525
Phone (970) 223-2117

Organizations & group practices 3

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": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1043523129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SOUTH COLLEGE AVE",
            "address_2": "SUITE 120",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252654",
            "telephone_number": "970-223-5030",
            "fax_number": "970-223-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 S COLLEGE AVE",
            "address_2": "SUITE 120",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252643",
            "telephone_number": "970-223-5030",
            "fax_number": "970-223-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAGARZA",
        "first_name": "LORENA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0003281",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7346TG",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.