Individual provider Active NPI

Jean Louise Demoss, O.D.

  • Optometrist
  • Wheat Ridge, CO
National Provider Identifier
1093750424
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2106 Issued in CO
Practice address
4875 Ward Road
Suite 600
Wheat Ridge, CO 80033
Phone
(303) 456-9456
Fax
(303) 463-7560
NPI assigned
Jun 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X OPT.0002106 CO
Optometrist 152W00000X 2106 CO Primary

Addresses

Primary practice location

4875 Ward Road
Suite 600
Wheat Ridge, CO 80033

Mailing address

4875 Ward Road
Suite 600
Wheat Ridge, CO 80033
Phone (303) 456-9456

Other identifiers 1

IdentifierTypeStateIssuer
10851356MedicaidCO

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
I20101007001127 CO Practitioner - Optometry 6800088923 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Vision Center, PCGroup PAC ID 9234122219, 3 clinicians

Practice addresses (Care Compare)

12810 W Alameda Pkwy
Unit B
Lakewood, CO 80228-3116
Phone (303) 986-5565

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.0002106COMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Eye Physicians P.C. Pediatrics CurrentSince Sep 1, 2002 Accepting new patients
Children's Eye Physicians P.C. Pediatrics CurrentSince Sep 1, 2002 Accepting new patients
Foothills Vision Center, PC Optometrist CurrentSince Aug 1, 2022 Accepting new patients

Locations

9094 E Mineral Cir
Ste 200
Centennial, CO 80112
Phone (303) 488-0000

3464 S Willow St
Ste 410
Denver, CO 80231

3464 S Willow St
Ste 200
Denver, CO 80231

12810 W Alameda Pkwy
Unit B
Lakewood, CO 80228
Phone (303) 986-5565

4875 Ward Rd
Ste 600
Wheat Ridge, CO 80033

Interoperability endpoints

  • Direct secure messaging: jean.demoss.p1@direct.cepcolorado.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1093750424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4875 WARD ROAD",
            "address_2": "SUITE 600",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "80033",
            "telephone_number": "303-456-9456",
            "fax_number": "303-463-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4875 WARD ROAD",
            "address_2": "SUITE 600",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "80033",
            "telephone_number": "303-456-9456",
            "fax_number": "303-463-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMOSS",
        "first_name": "JEAN",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CO",
            "license": "OPT.0002106",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10851356",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

Verify at the official NPI Registry.