NPIMap

Organization Active NPI

Corneal Consultants of Colorado PC

Doing business as County Line Optical

  • Eyewear Supplier
  • Littleton, CO
National Provider Identifier
1326032418
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
CORNEAL CONSULTANTS OF COLORADO PC
Doing business as
County Line Optical
Practice address
1501 W Mineral Ave Ste 100
Littleton, CO 80120-5612
Phone
(303) 730-8024
Fax
(303) 730-6163
NPI assigned
Sep 6, 2005
Last updated
Aug 19, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
CORNEAL CONSULTANTS OF COLORADO PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Authorized official

Name
Mr. Martin Rios
Title
Revenue Manager
Phone
(303) 730-0404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU Primary

Addresses

Primary practice location

1501 W Mineral Ave Ste 100
Littleton, CO 80120-5612

Mailing address

1501 W Mineral Ave Ste 100
Littleton, CO 80120-5612
Phone (303) 730-8024

Other identifiers 2

IdentifierTypeStateIssuer
04005146MedicaidCO
CB4508OtherBLUE CROSS BLUE SHIELD

Other names 1

  • COUNTY LINE OPTICAL Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130515000553 CO DME Supplier - Physician - Ophthalmology 1153210380 Practice locations: Littleton, CO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Corneal Consultants of Colo2 organizations share this tax ID, including this one
Part of
Corneal Consultants of Colo

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1501 W Mineral Ave
Ste 100
Littleton, CO 80120
Phone (303) 730-0404

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629331200000",
    "number": "1326032418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 W MINERAL AVE STE 100",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205612",
            "telephone_number": "303-730-8024",
            "fax_number": "303-730-6163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W MINERAL AVE STE 100",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205612",
            "telephone_number": "303-730-8024",
            "fax_number": "303-730-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNEAL CONSULTANTS OF COLORADO PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORNEAL CONSULTANTS OF COLORADO PC",
        "enumeration_date": "2005-09-06",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A",
        "authorized_official_last_name": "RIOS",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "REVENUE MANAGER",
        "authorized_official_telephone_number": "303-730-0404",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04005146",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "CB4508",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COUNTY LINE OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.