Philip Wren, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1938 Issued in CO

Practice address

6545 Gunpark Dr
Ste 250
Boulder, CO 80301-3347

Phone

(303) 530-1973

Fax

(720) 638-1223

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Colorado PCGroup PAC ID 7113359415, 58 clinicians

Simple Optical IncGroup PAC ID 8123347515, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Simple Optical, Inc.

  • Optometrist
  • Boulder, CO
  • NPI 1518352699
  Medicare reassignment Care Compare group NPD Authorized official
• Myeyedr Optometry of Colorado PC

  • Optometrist
  • Parker, CO
  • NPI 1174170526
  Medicare reassignment Care Compare group NPD
• Simple Optical, Inc

  • Optometrist
  • Denver, CO
  • NPI 1477126654
  NPD (past) Authorized official
• Simple Optical, Inc

  • Optometrist
  • Wheat Ridge, CO
  • NPI 1518615848
  NPD (past) Authorized official
• Simple Optical, Inc

  • Optometrist
  • Denver, CO
  • NPI 1780393264
  NPD (past) Authorized official
• Simple Optical, Inc.

  • Optometrist
  • Broomfield, CO
  • NPI 1144805334
  NPD (past) Authorized official
• Simple Optical, Inc.

  • Optometrist
  • Denver, CO
  • NPI 1164017570
  NPD (past) Authorized official
• Myeyedr Optometry of Colorado PC

  • Optometrist
  • Parker, CO
  • NPI 1164382842
  NPD
• Myeyedr Optometry of Colorado PC

  • Optometrist
  • Broomfield, CO
  • NPI 1326809070
  NPD

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1255404802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 GUNPARK DR",
            "address_2": "STE 250",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013347",
            "telephone_number": "303-530-1973",
            "fax_number": "720-638-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 GUNPARK DR",
            "address_2": "STE 250",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013347",
            "telephone_number": "303-530-1973",
            "fax_number": "720-638-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WREN",
        "first_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11798239",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "69172587",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laey Woolf
• Marlisa Wootton, AUD
• Jessica Worley, LCSW
• Melanie Worley, DO
• Timothy R Worley, PT, DPT
• Amber Wright
• Bryce Wright, PA
• Charlie Wright, M.A., LSP
• Chloe Wright
• Elyssa Marie Wright, DC

• Optometrist in Boulder, CO
• Providers in Boulder, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.

Verify at the official NPI Registry.