Individual provider Active NPI

Brian L Vincent, O.D.

  • Optometrist
  • Evergreen, CO
National Provider Identifier
1194769844
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2339 Issued in CO
Practice address
952 Swede Gulch Rd
Evergreen, CO 80439-3713
Phone
(303) 526-0534
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation Optometrist 152WL0500X 2339 CO
Optometrist 152W00000X 2339 CO Primary

Addresses

Primary practice location

952 Swede Gulch Rd
Evergreen, CO 80439-3713

Mailing address

PO Box 1530
Golden, CO 80402-1530
Phone (303) 653-6255

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
I20051205000115 CO Practitioner - Optometry 1052331113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

952 Swede Gulch Rd
Evergreen, CO 80439-3713
Phone (303) 526-0534

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2339COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Eye Clinic LLC CurrentSince Feb 21, 2019 Accepting new patients

Locations

952 Swede Gulch Rd
Golden, CO 80439
Phone (303) 526-0534

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1194769844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1530",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804021530",
            "telephone_number": "303-653-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "952 SWEDE GULCH RD",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804393713",
            "telephone_number": "303-526-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "BRIAN",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "CO",
            "license": "2339",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

Verify at the official NPI Registry.