Individual provider Active NPI

Katheryn Janelle Engel, OD

  • Optometrist
  • Fort Collins, CO
National Provider Identifier
1255016994
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3936 Issued in CO
Practice address
1037 Robertson St
Fort Collins, CO 80524-3926
Phone
(970) 224-0606
NPI assigned
Jun 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3936 CO Primary

Addresses

Primary practice location

1037 Robertson St
Fort Collins, CO 80524-3926

Mailing address

1037 Robertson St
Fort Collins, CO 80524-3926
Phone (970) 224-0606

Other practice location 1

1250 E Magnolia St
Fort Collins, CO 80524-2702
Phone (970) 224-0606

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
I20240607002061 CO Practitioner - Optometry 6800338682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Eyecare, PCGroup PAC ID 7911896378, 2 clinicians

Practice addresses (Care Compare)

1037 Robertson St
Fort Collins, CO 80524-3926
Phone (970) 224-0606

1250 E Magnolia St
Fort Collins, CO 80524-2702
Phone (970) 224-0606

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3936COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Eye Care, PC Optometrist CurrentSince Mar 31, 2024 Accepting new patients
Jackson Eyecare, PC Optometrist CurrentSince Mar 31, 2024 Accepting new patients

Locations

1250 E Magnolia St
Fort Collins, CO 80524
Phone (970) 224-0606

1037 Robertson St
Fort Collins, CO 80524
Phone (970) 224-0606

Organizations & group practices 2

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": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1255016994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 ROBERTSON ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243926",
            "telephone_number": "970-224-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 ROBERTSON ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243926",
            "telephone_number": "970-224-0606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Magnolia St",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805242702",
            "country_code": "US",
            "telephone_number": "970-224-0606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENGEL",
        "first_name": "KATHERYN",
        "middle_name": "JANELLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "3936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.