NPIMap

Jason Jost OD PC

Organization Active NPI Optometrist · Colorado Springs, CO

NPI 1164630588 · NPPES record last updated Nov 18, 2019

Key facts

NPI
1164630588
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
License
867 (CO)
Legal business name
JASON JOST OD PC
Practice address
710 N Circle Dr
Colorado Springs, CO 80909
Phone
(719) 632-1587
Fax
(719) 632-1563
NPI assigned
May 18, 2007
Organization subpart
No

Authorized official

Name
Jason Jost, OD NPI 1316907314
Title
Owner
Phone
(719) 632-1587

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2073772Pikes Peak Eye Care
710 North Circle Dr, Colorado Springs, CO 80909		Certificate of waiverFeb 23, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040916001164 CO Part B Supplier - Clinic/Group Practice 4183691272 Receives reassigned benefits from 4 practitioners
Practice locations: Colorado SPGS, CO

National Provider Directory

Locations

710 N Circle Dr
Colorado Springs, CO 80909
Phone (719) 632-1587

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 152W00000X
Optometrist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 152W00000X 867 CO Yes

Addresses

Primary practice location

710 N Circle Dr
Colorado Springs, CO 80909

Mailing address

710 N Circle Dr
Colorado Springs, CO 80909
Phone (719) 632-1587

Other identifiers

IdentifierTypeStateIssuer
08008674MedicaidCO

Other names

  • Pikes Peak Eye Care Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 18, 2019.

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1164630588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N CIRCLE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80909",
            "telephone_number": "719-632-1587",
            "fax_number": "719-632-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N CIRCLE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80909",
            "telephone_number": "719-632-1587",
            "fax_number": "719-632-1563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON JOST OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2019-11-18",
        "status": "A",
        "authorized_official_last_name": "JOST",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-632-1587",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08008674",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pikes Peak Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pikes Peak Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

All providers in Colorado Springs, CO · Optometrist in Colorado

Sources for this page

Verify at the official NPI Registry.