Active NPI
George Mamalis, O.D.
- Optometrist
- Lakewood, CO
National Provider Identifier
1275501967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1316
- Practice address
- 255 Union Blvd Ste 310
Lakewood, CO 80228-1863 - Phone
- (303) 985-0004
- Fax
- (303) 985-0037
- NPI assigned
- Mar 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1316 | CO | Primary |
Addresses
Primary practice location
255 Union Blvd Ste 310
Lakewood, CO 80228-1863
Mailing address
255 Union Blvd Ste 310
Lakewood, CO 80228-1863
Phone (303) 985-0004
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316 | Other | CO | STATE LICENSE NO |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041115001093 | CO | Practitioner - Optometry | 5991769416 | Practice locations: Lakewood, CO |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of California - School of Optometry, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
255 Union Blvd
Suite 310
Lakewood, CO 80228-1863
Phone (303) 985-0004
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1316 | CO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594252800000",
"number": "1275501967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 UNION BLVD STE 310",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802281863",
"telephone_number": "303-985-0004",
"fax_number": "303-985-0037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 UNION BLVD STE 310",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802281863",
"telephone_number": "303-985-0004",
"fax_number": "303-985-0037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAMALIS",
"first_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-09",
"last_updated": "2020-07-09",
"certification_date": "2020-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "1316",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NO",
"identifier": "1316",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.