Individual provider Active NPI

Julia Christine Polito, O.D.

  • Optometrist
  • Northglenn, CO
National Provider Identifier
1306947874
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2549 Issued in CO
Practice address
10669 Melody Dr
Northglenn, CO 80234-4113
Phone
(303) 452-9312
Fax
(303) 452-3515
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2549 CO Primary

Addresses

Primary practice location

10669 Melody Dr
Northglenn, CO 80234-4113

Mailing address

10669 Melody Dr
Northglenn, CO 80234-4113
Phone (303) 452-9312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20110718000523 ID Practitioner - Optometry 7416988019 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2549COMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wilson Polito PLLC Optometrist CurrentSince May 2, 2011 Accepting new patients
Wilson Polito PLLC Optometrist Current Accepting new patients
Stephen Brockbank O.D. L.L.C. Optometrist PastSince Jun 1, 2011 Accepting new patients
Richard W. Baker, O.D. Optometrist Past Accepting new patients
Flatirons Optometric Group, PC Optometrist PastSince Sep 12, 2021 Accepting new patients

Locations

739 Bryden Ave
#A
Lewiston, ID 83501
Phone (208) 743-5830

1844 W Pullman Rd
Moscow, ID 83843
Phone (208) 883-1800

Organizations & group practices 5

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306947874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10669 MELODY DR",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802344113",
            "telephone_number": "303-452-9312",
            "fax_number": "303-452-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10669 MELODY DR",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802344113",
            "telephone_number": "303-452-9312",
            "fax_number": "303-452-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLITO",
        "first_name": "JULIA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northglenn, CO

Sources for this page

Verify at the official NPI Registry.