NPIMap

Organization Active NPI

Colorado Eye Center, LLC

  • Optometrist
  • Thornton, CO
National Provider Identifier
1154592228
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
COLORADO EYE CENTER, LLC
Practice address
12450 York St
Thornton, CO 80241-2741
Phone
(303) 452-2020
Fax
(303) 452-0934
NPI assigned
Mar 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Authorized official

Name
Mr. George Neal
Title
Chief Executive Officer
Phone
(844) 377-6468

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

12450 York St
Thornton, CO 80241-2741

Mailing address

4 Garden Ctr Ste 100
Broomfield, CO 80020-7090
Phone (303) 469-1941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040309000069 CO Part B Supplier - Clinic/Group Practice 7012805328 Receives reassigned benefits from 14 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Thorton, CO; Thornton, CO; Broomfield, CO; Boulder, CO; Parker, CO
O20100930058753 CO DME Supplier - Physician - OptometristDME Supplier - Optician 7012805328 Practice locations: Thornton, CO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Colorado Eye Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

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": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606694400000",
    "number": "1154592228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GARDEN CTR STE 100",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207090",
            "telephone_number": "303-469-1941",
            "fax_number": "303-469-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 YORK ST",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802412741",
            "telephone_number": "303-452-2020",
            "fax_number": "303-452-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO EYE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "844-377-6468",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.

Verify at the official NPI Registry.