Individual provider Active NPI

Joseph Alexander Gowen, O.D.

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1144246307
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2486 Issued in CO
Practice address
1130 Lake Plaza Dr
Suite 230
Colorado Springs, CO 80906-3594
Phone
(719) 219-3819
Fax
(719) 219-0411
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2486 CO Primary

Addresses

Primary practice location

1130 Lake Plaza Dr
Suite 230
Colorado Springs, CO 80906-3594

Mailing address

1130 Lake Plaza Dr
Suite 230
Colorado Springs, CO 80906-3594
Phone (719) 219-3819

Other identifiers 1

IdentifierTypeStateIssuer
90000552MedicaidCO

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
I20110407000154 CO Practitioner - Optometry 7416131990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4420 N Fwy Rd
Pueblo, CO 81008-2062

4420N Fwy Rd
Pueblo, CO 81008-2062
Phone (719) 296-6597

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2486COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Gowen, O.D. and Associates, LLC Optometrist CurrentSince Jul 25, 2012 Accepting new patients
Abba Eye Care PC Optometrist Past Accepting new patients

Locations

4420 N Freeway Rd
Pueblo, CO 81008
Phone (719) 296-6597

Organizations & group practices 2

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1144246307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 LAKE PLAZA DR",
            "address_2": "SUITE 230",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063594",
            "telephone_number": "719-219-3819",
            "fax_number": "719-219-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 LAKE PLAZA DR",
            "address_2": "SUITE 230",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063594",
            "telephone_number": "719-219-3819",
            "fax_number": "719-219-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWEN",
        "first_name": "JOSEPH",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90000552",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.