Individual provider Active NPI

Melissa Anne Tada, OPTOMETRIST

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1154385169
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2048 Issued in CO
Practice address
6071 E Woodmen Rd
Suite 205
Colorado Springs, CO 80923-2607
Phone
(719) 380-6808
Fax
(719) 380-5656
NPI assigned
Apr 14, 2006
Last updated
Jul 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 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 2048 CO Primary

Addresses

Primary practice location

6071 E Woodmen Rd
Suite 205
Colorado Springs, CO 80923-2607

Mailing address

1865 Anasazi CT
Colorado Springs, CO 80919-3487
Phone (719) 380-6808

Other identifiers 2

IdentifierTypeStateIssuer
809893OtherCOMEDICARE PTAN
01330357MedicaidCO

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
I20070906000543 CO Practitioner - Optometry 0749373785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Vision PCGroup PAC ID 9830282797, 4 clinicians

Practice addresses (Care Compare)

7435 Sisters GRV
Suite 210
Colorado Springs, CO 80923-2609

7435 Sisters GRV
Suite 210
Colorado Springs, CO 80923-2620
Phone (719) 380-6808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2048COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Vision, PC Optometrist CurrentSince Aug 1, 2007 Accepting new patients
Jason Jost OD PC Optometrist PastSince Aug 29, 2007 Accepting new patients
Chapel Hills Vision P C Optometrist Past Accepting new patients

Locations

6071 E Woodmen Rd
Ste 205
Colorado Springs, CO 80923
Phone (719) 380-6808

Interoperability endpoints

  • Direct secure messaging: mtada@mvvision.eyefinity-direct.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1154385169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 ANASAZI CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193487",
            "telephone_number": "719-380-6808",
            "fax_number": "719-380-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 E WOODMEN RD",
            "address_2": "SUITE 205",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809232607",
            "telephone_number": "719-380-6808",
            "fax_number": "719-380-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADA",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "809893",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01330357",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.