Individual provider Active NPI

Richard Cross, O.D.

  • Optometrist
  • Boulder, CO
National Provider Identifier
1164512257
Registry record updated Jan 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1436 Issued in CO
Practice address
5305 Spine Rd
Suite B
Boulder, CO 80301-3331
Phone
(303) 530-2020
Fax
(303) 530-1072
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1436 CO Primary
Corneal and Contact Management Optometrist 152WC0802X 1436 CO

Addresses

Primary practice location

5305 Spine Rd
Suite B
Boulder, CO 80301-3331

Mailing address

5305 Spine Rd
Suite B
Boulder, CO 80301-3331
Phone (303) 530-2020

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
I20071220000576 CO Practitioner - Optometry 9436249927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5305 Spine Rd
Suite B
Boulder, CO 80301-3331
Phone (303) 530-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1436COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Vision Associates, P.C., Inc. Optometrist CurrentSince Jul 1, 2008 Accepting new patients

Locations

5365 Spine Rd
Ste B
Boulder, CO 80301
Phone (303) 530-2020

5305 Spine Rd
Ste B
Boulder, CO 80301
Phone (303) 530-2020

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232928000000",
    "number": "1164512257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 SPINE RD",
            "address_2": "SUITE B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013331",
            "telephone_number": "303-530-2020",
            "fax_number": "303-530-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 SPINE RD",
            "address_2": "SUITE B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013331",
            "telephone_number": "303-530-2020",
            "fax_number": "303-530-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSS",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2009-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1436",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CO",
            "license": "1436",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.