William G Self Jr MD PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

WILLIAM G SELF JR MD PC

Doing business as

Eye Surgery Center of Colorado PC

Practice address

8403 Bryant St
Westminster, CO 80031-3809

Phone

(303) 426-4810

Fax

(303) 426-8708

NPI assigned

Oct 31, 2006

Last updated

Jul 15, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Terri Lynn Morgan

Title

Billing Dept

Phone

(303) 920-2685

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Eye Surgery Center of Colorado PC Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093891244. Details of each certification follow.

• CCN 06C0001011 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 06C0001011

Legal name

EYE SURGERY CENTER OF COLORADO

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Dec 2, 1985

Last certification

Jan 16, 2019

Ownership / control type

Proprietary

Facility address

8403 Bryant St
Westminster, CO 80031

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373846400000",
    "number": "1093891244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8403 BRYANT ST",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800313809",
            "telephone_number": "303-426-4810",
            "fax_number": "303-426-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8403 BRYANT ST",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800313809",
            "telephone_number": "303-426-4810",
            "fax_number": "303-426-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM G SELF JR MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2013-07-15",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BILLING DEPT",
        "authorized_official_telephone_number": "303-920-2685",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04017513",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN6824",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Surgery Center of Colorado PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Morgan Justine Wilcox, PT, DPT
• Jordan Wilkes, DO
• Juliana Wilking-Johnson, M.D.
• Faith Wilkins, OTR/L
• Cheryl M Willett, RN
• William G Self Jr MD PC
• Bri Williams
• Christine Rose Williams, R.M.T.
• Courtney Williams
• Isabella Williams, RBT

• Ophthalmology Physician in Westminster, CO
• Providers in Westminster, CO by specialty
• Ophthalmology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.