NPIMap

Organization Active NPI

Total Vision Eye Care Group, LLC

  • Clinic/Center
  • Golden, CO
National Provider Identifier
1245814367
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
TOTAL VISION EYE CARE GROUP, LLC
Practice address
350 Indiana St Ste 220
Golden, CO 80401-5050
Phone
(720) 524-1001
Fax
(720) 524-1121
NPI assigned
May 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Authorized official

Name
Brett Ehrhardt
Title
Cfo
Phone
(720) 358-0218

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

350 Indiana St Ste 220
Golden, CO 80401-5050

Mailing address

3900 E Mexico Ave Ste 102
Denver, CO 80210-3941
Phone (480) 641-3937

Other names 1

  • ICON EyeCare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040205001077 CO Part B Supplier - Clinic/Group Practice 2163315854 Receives reassigned benefits from 28 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Denver, CO; Westminster, CO; Grand Junction, CO; Golden, CO; Fort Collins, CO; Englewood, CO; Basalt, CO; Aurora, CO

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
Total Vision Eye Care G10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1245814367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 E MEXICO AVE STE 102",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802103941",
            "telephone_number": "480-641-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 INDIANA ST STE 220",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804015050",
            "telephone_number": "720-524-1001",
            "fax_number": "720-524-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL VISION EYE CARE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "EHRHARDT",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "720-358-0218"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ICON EyeCare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ICON EyeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Golden, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.