NPIMap

Organization Active NPI

Raza Uddin OD LLC

  • Optometrist
  • Trinidad, CO
National Provider Identifier
1215734181
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
RAZA UDDIN OD LLC
Practice address
409 Benedicta Ave
Trinidad, CO 81082-2004
Phone
(719) 846-9291
NPI assigned
Feb 27, 2025
Last updated
Feb 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Authorized official

Name
Raza UddinNPI 1942455670
Title
Owner
Phone
(303) 383-9377

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

409 Benedicta Ave
Trinidad, CO 81082-2004

Mailing address

8239 S Kearney St
Centennial, CO 80112-3002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250106002009 CO Part B Supplier - Clinic/Group Practice 8628506524 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Junction, CO; Trinidad, CO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Raza Uddin OD LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1215734181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8239 S KEARNEY ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801123002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 BENEDICTA AVE",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822004",
            "telephone_number": "719-846-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAZA UDDIN OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "UDDIN",
        "authorized_official_first_name": "RAZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-383-9377"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinidad, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.