Active NPI
San Juan Eye Centers, PC
- Optometrist
- Montrose, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2592
- Legal business name
- SAN JUAN EYE CENTERS, PC
- Practice address
- 1805 S Hillcrest Dr
Montrose, CO 81401-4408 - Phone
- (970) 249-2020
- Fax
- (970) 249-1505
- NPI assigned
- Dec 17, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jared F Hadlock, OD
- Title
- President
- Phone
- (970) 249-2020
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2592 | CO | Primary |
Addresses
Primary practice location
1805 S Hillcrest Dr
Montrose, CO 81401-4408
Mailing address
1805 S Hillcrest Dr
Montrose, CO 81401-4408
Phone (970) 249-2020
Other practice location 1
164 W. 3rd St Delta
Delta, CO 81416-1842
Phone (970) 874-8110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140409000984 | CO | Part B Supplier - Clinic/Group Practice | 3072745843 |
Receives reassigned benefits from 4 practitioners Practice locations: Montrose, CO; Delta, CO |
National Provider Directory
National Provider Directory- Tax ID family
- San Juan Eye Centers PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Montrose, CO
- NPI 1518763606
Locations
330 S 12th St
Ste D
Montrose, CO 81401
Phone (970) 249-2020
1805 S Hillcrest Dr
Montrose, CO 81401
Phone (970) 249-2020
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Optometrist
- Montrose, CO
- NPI 1518763606
Practitioners 4
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": "1387238400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1614729600000",
"number": "1124449145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1805 S HILLCREST DR",
"city": "MONTROSE",
"state": "CO",
"postal_code": "814014408",
"telephone_number": "970-249-2020",
"fax_number": "970-249-1505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1805 S HILLCREST DR",
"city": "MONTROSE",
"state": "CO",
"postal_code": "814014408",
"telephone_number": "970-249-2020",
"fax_number": "970-249-1505"
}
],
"practiceLocations": [
{
"address_1": "164 W. 3rd St Delta",
"address_purpose": "LOCATION",
"city": "Delta",
"state": "CO",
"postal_code": "814161842",
"country_code": "US",
"telephone_number": "970-874-8110",
"fax_number": "970-874-5348",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SAN JUAN EYE CENTERS, PC",
"organizational_subpart": "NO",
"enumeration_date": "2013-12-17",
"last_updated": "2021-03-03",
"certification_date": "2021-02-11",
"status": "A",
"authorized_official_last_name": "HADLOCK",
"authorized_official_first_name": "JARED",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "970-249-2020",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "CO",
"license": "2592",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montrose, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.