NPIMap

Individual provider Active NPI

Angela Joann Demetrulias, OD

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1194013086
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003857 Issued in CO
Practice address
5201 Mid America PLZ
Div Opthalmology, Ste 2500
Saint Louis, MO 63129-0002
Phone
(314) 273-0020
Fax
(314) 273-0033
NPI assigned
Jul 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2016024156 MO
Optometrist 152W00000X OPT.0003857 CO Primary

Addresses

Primary practice location

5201 Mid America PLZ
Div Opthalmology, Ste 2500
Saint Louis, MO 63129-0002

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

1675 Aurora Ct Ste F731
Aurora, CO 80045-2592
Phone (720) 848-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121011000828 IN Practitioner - Optometry 3779740931 Reassigns benefits to 1 organization
I20230123000799 CO Practitioner - Optometry 3779740931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

1675 Aurora CT
Aurora, CO 80045-2517
Phone (720) 848-0000

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Holicki Eye Centers, P.C. Optometrist CurrentSince Oct 21, 2013 Accepting new patients
University Physicians Incorporated CurrentSince Feb 1, 2023 Accepting new patients
University Physicians Incorporated Current Accepting new patients
University Physicians, Incorporated CurrentSince Feb 1, 2023 Accepting new patients
Midwest Eye Consultants, P.C. Optometrist Past Accepting new patients
University Physicians, Incorporated Past Accepting new patients
Holicki Optical Inc Optometrist Past Accepting new patients

Locations

1675 Aurora Ct
Ste F731
Aurora, CO 80045
Phone (720) 848-2020

1675 Aurora Ct
Aurora, CO 80045
Phone (720) 748-2020

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

Dept 1061
Denver, CO 80256

9552 Park Meadows Dr
Ste 100
Lone Tree, CO 80124
Phone (720) 848-2020

9548 Park Meadows Dr
Lone Tree, CO 80124
Phone (720) 848-2200

1202 N Wayne St
Angola, IN 46703
Phone (260) 665-2825

142 E Chicago Rd
Coldwater, MI 49036
Phone (517) 279-7927

142 E Chicago Rd
Ste A
Coldwater, MI 49036
Phone (517) 279-7927

Interoperability endpoints

  • Direct secure messaging: ademetrulias159572@direct.carenet.org

Organizations & group practices 7

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.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1194013086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 MID AMERICA PLZ",
            "address_2": "DIV OPTHALMOLOGY, STE 2500",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631290002",
            "telephone_number": "314-273-0020",
            "fax_number": "314-273-0033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Aurora Ct Ste F731",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800452592",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMETRULIAS",
        "first_name": "ANGELA",
        "middle_name": "JOANN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2016024156",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.