Organization Active NPI

Wolf, OD PC

Doing business as Family Eyecare of Brighton

  • Optometrist
  • Brighton, CO
National Provider Identifier
1235104233
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT1833 Issued in CO
Legal business name
WOLF, OD PC
Doing business as
Family Eyecare of Brighton
Practice address
193 S 27TH Ave Ste 400
Brighton, CO 80601-2662
Phone
(303) 654-7933
Fax
(303) 637-9002
NPI assigned
Feb 22, 2006
Last updated
Oct 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Authorized official

Name
Jena Wolf, ODNPI 1396256889
Title
Owner
Phone
(605) 280-6029

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT1833 CO Primary

Addresses

Primary practice location

193 S 27TH Ave Ste 400
Brighton, CO 80601-2662

Mailing address

193 S 27TH Ave
Ste 400
Brighton, CO 80601-2662
Phone (303) 654-7933

Other names 1

  • Family Eyecare of Brighton Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131025000517 CO Part B Supplier - Clinic/Group Practice 0840425914 Receives reassigned benefits from 2 practitioners
Practice locations: Brighton, CO

National Provider Directory

National Provider Directory

Locations

193 S 27th Ave
Ste 4000
Brighton, CO 80601

193 S 27th Ave
Brighton, CO 80601
Phone (303) 654-7933

193 S 27th Ave
Ste 400
Brighton, CO 80601
Phone (303) 654-7933

Practitioners & affiliated clinicians

Practitioners 6

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": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1235104233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 S 27TH AVE",
            "address_2": "STE 400",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012662",
            "telephone_number": "303-654-7933",
            "fax_number": "303-637-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 S 27TH AVE STE 400",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012662",
            "telephone_number": "303-654-7933",
            "fax_number": "303-637-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLF, OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "JENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-280-6029",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT1833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Eyecare of Brighton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brighton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.