Active NPI
Brian L Vincent, O.D.
- Optometrist
- Evergreen, CO
National Provider Identifier
1194769844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2339
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2339 | CO | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foothills Eye Clinic LLC | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.