Active NPI
John A Molinario, O.D.
- Optometrist
- Fort Collins, CO
National Provider Identifier
1083701627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1171
- Practice address
- 1015 So Taft Hill Rd #J
Fort Collins, CO 80521 - Phone
- (970) 482-6034
- Fax
- (970) 484-4146
- NPI assigned
- Oct 6, 2006
- Reactivated
- Apr 3, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1171 | CO | Primary |
Addresses
Primary practice location
1015 So Taft Hill Rd #J
Fort Collins, CO 80521
Mailing address
2178 Cape Hatteras Dr Unit 10
Windsor, CO 80550-7229
Phone (970) 430-4498
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62821547 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1171 | CO | MD | Surgical Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wiarda Optometry, PLLC | Optometrist | Past | Accepting new patients |
Organizations & group practices 6
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.
-
- Optometrist
- Longmont, CO
- NPI 1093318651
-
- Optometrist
- Greeley, CO
- NPI 1699129841
-
dba Dr John a. Molinario, Optometrist
- Optometrist
- Evans, CO
- NPI 1699300020
-
- Optometrist
- Loveland, CO
- NPI 1053070466
-
- Optometrist
- Fort Collins, CO
- NPI 1093958514
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585872000000",
"number": "1083701627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2178 CAPE HATTERAS DR UNIT 10",
"city": "WINDSOR",
"state": "CO",
"postal_code": "805507229",
"telephone_number": "970-430-4498",
"fax_number": "970-833-5510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 SO TAFT HILL RD #J",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "80521",
"telephone_number": "970-482-6034",
"fax_number": "970-484-4146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOLINARIO",
"first_name": "JOHN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2020-04-03",
"certification_date": "2020-04-03",
"deactivation_date": "2020-03-03",
"reactivation_date": "2020-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "1171",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "62821547",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.