Individual provider Active NPI

Heather N Kim, OD

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1154761765
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2988 Issued in CO
Practice address
3070 N Powers Blvd
Colorado Springs, CO 80922-2803
Phone
(719) 505-7334
Fax
(719) 505-7335
NPI assigned
Jun 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2988 CO Primary

Addresses

Primary practice location

3070 N Powers Blvd
Colorado Springs, CO 80922-2803

Mailing address

670 Coveglen CT
Colorado Springs, CO 80906-6800
Phone (719) 500-1203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130827000159 CO Practitioner - Optometry 7517100316 Reassigns benefits to 2 organizations
I20221116002392 NY Practitioner - Optometry 7517100316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3070 N Powers Blvd
Colorado Springs, CO 80922-2803
Phone (719) 505-7334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2988COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Eye Center Inc a Colorado Provider Network Optometrist Current Accepting new patients
Juniper Eye Care, PC Optometrist CurrentSince Mar 13, 2023 Accepting new patients
Empire Vision Center, Inc CurrentSince Jul 26, 2022 Accepting new patients
Rocky Mountain Eye Center Inc a Colorado Provider Network Optometrist CurrentSince Jun 20, 2016 Accepting new patients
Empire Vision Center Inc Optometrist CurrentSince Jul 26, 2022 Accepting new patients

Locations

3070 N Powers Blvd
Colorado Springs, CO 80922
Phone (719) 505-7334

27 Montebello Rd
Pueblo, CO 81001
Phone (719) 545-1530

2680 Delaware Ave
Ste C
Buffalo, NY 14216
Phone (716) 873-1241

560 Troy Schenectady Rd
#7
Latham, NY 12110
Phone (518) 783-0090

1930 South Rd
#105
Poughkeepsie, NY 12601
Phone (845) 298-3200

2590 W Ridge Rd
Rochester, NY 14626
Phone (585) 227-7150

2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 446-3145

Organizations & group practices 5

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": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1154761765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 COVEGLEN CT",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809066800",
            "telephone_number": "719-500-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 N POWERS BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809222803",
            "telephone_number": "719-505-7334",
            "fax_number": "719-505-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HEATHER",
        "middle_name": "N",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.