NPIMap

Organization Active NPI

Front Range Eye Health Center, P.C.

  • Optometrist
  • Louisville, CO
National Provider Identifier
1295950848
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FRONT RANGE EYE HEALTH CENTER, P.C.
Practice address
1220 Summit View Drive
Louisville, CO 80027
Phone
(303) 665-7797
NPI assigned
Apr 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Authorized official

Name
Mansur Nurdel, O.D.NPI 1023166204
Title
President
Phone
(303) 665-7797

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 CO Primary

Addresses

Primary practice location

1220 Summit View Drive
Louisville, CO 80027

Mailing address

1220 Summit View Drive
Louisville, CO 80027

Other identifiers 1

IdentifierTypeStateIssuer
04014510MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324001614 CO Part B Supplier - Clinic/Group Practice 9638060817 Receives reassigned benefits from 9 practitioners
Practice locations: Louisville, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1295950848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 SUMMIT VIEW DRIVE",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "80027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 SUMMIT VIEW DRIVE",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "80027",
            "telephone_number": "303-665-7797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONT RANGE EYE HEALTH CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "NURDEL",
        "authorized_official_first_name": "MANSUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-665-7797",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04014510",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.