Individual provider Active NPI

Caitlyn Anna Lee Wong, OD

  • Optometrist
  • Denver, CO
National Provider Identifier
1194371138
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003521 Issued in CO
Practice address
1407 W 84TH Ave Unit B8
Denver, CO 80260-4753
Phone
(720) 214-4746
NPI assigned
Aug 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.0003521 CO Primary

Addresses

Primary practice location

1407 W 84TH Ave Unit B8
Denver, CO 80260-4753

Mailing address

2221 E Bijou St Ste 100
Colorado Springs, CO 80909-8009
Phone (719) 576-1850

Other identifiers 1

IdentifierTypeStateIssuer
OPT.0003521OtherCOCO OPTOMETRY LICENSE

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
I20220921003388 CO Practitioner - Optometry 8921483330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Vista Eye Care, PCGroup PAC ID 8123152113, 9 clinicians

Practice addresses (Care Compare)

13695 Colorado Blvd
Thornton, CO 80602-7051
Phone (303) 450-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Eye Care, PC Optometrist CurrentSince Nov 2, 2022 Accepting new patients
Vision & Eye Health Associates Optometrist PastSince Nov 2, 2022 Accepting new patients

Locations

13695 Colorado Blvd
Thornton, CO 80602
Phone (303) 450-2020

Organizations & group practices 2

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": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1194371138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 E BIJOU ST STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809098009",
            "telephone_number": "719-576-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 W 84TH AVE UNIT B8",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802604753",
            "telephone_number": "720-214-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "CAITLYN",
        "middle_name": "ANNA LEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO OPTOMETRY LICENSE",
            "identifier": "OPT.0003521",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.