Active NPI
Nathaniel Jensen, OD
- Optometrist
- Colorado Springs, CO
National Provider Identifier
1154055986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT.0003794
- Practice address
- 7190 N Academy Blvd
Colorado Springs, CO 80920-3185 - Phone
- (801) 850-1896
- NPI assigned
- Jul 16, 2022
- 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 | OPT.0003794 | CO | Primary |
Addresses
Primary practice location
7190 N Academy Blvd
Colorado Springs, CO 80920-3185
Mailing address
6511 Trenton St
Colorado Springs, CO 80923-5474
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
122 E 1700
BLDG 3
Provo, UT 84606-5644
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT.0003794 | CO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rocky Mountain University of Health Professions Foundation | Optometrist | Current | Accepting new patients |
Locations
122 E 1700 S
Bldg 3
Provo, UT 84606
Phone (385) 248-5550
Networks
- UT PPO
- UT PPO D-SNP
Organizations & group practices 1
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.
-
- Physical Therapist
- Provo, UT
- NPI 1053174417
Optometrist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657929600000",
"number": "1154055986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6511 TRENTON ST",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809235474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7190 N ACADEMY BLVD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809203185",
"telephone_number": "801-850-1896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "NATHANIEL",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-16",
"last_updated": "2022-07-16",
"certification_date": "2022-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "OPT.0003794",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.