Individual provider Active NPI

James Thomas Vancamp, OD

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1154441350
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT1190 Issued in CO
Practice address
1465 Kelly Johnson Blvd
Ste 110
Colorado Springs, CO 80920-3955
Phone
(719) 598-6000
Fax
(719) 559-0136
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT1190 CO Primary

Addresses

Primary practice location

1465 Kelly Johnson Blvd
Ste 110
Colorado Springs, CO 80920-3955

Mailing address

PO Box 1009
Monument, CO 80132-1009
Phone (719) 598-6000

Other identifiers 1

IdentifierTypeStateIssuer
08011900MedicaidCO

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
I20040414000455 CO Practitioner - Optometry 8628061751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5955 Lehman Dr
Colorado Springs, CO 80918-3434
Phone (719) 598-6000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Academy Vision Science Clinic PC CurrentSince Jul 1, 2002 Accepting new patients

Locations

1465 Kelly Johnson Blvd
Ste 110
Colorado Springs, CO 80920
Phone (719) 445-6077

5955 Lehman Dr
Colorado Springs, CO 80918
Phone (719) 593-1514

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.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1154441350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1009",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801321009",
            "telephone_number": "719-598-6000",
            "fax_number": "719-559-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD",
            "address_2": "STE 110",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203955",
            "telephone_number": "719-598-6000",
            "fax_number": "719-559-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCAMP",
        "first_name": "JAMES",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT1190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08011900",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.