Individual provider Active NPI

Anne-Marie Palmer, O.D

  • Optometrist
  • Longmont, CO
National Provider Identifier
1326398967
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0002995 Issued in CO
Practice address
1739 Main St
Longmont, CO 80501-2035
Phone
(303) 834-6400
Fax
(303) 834-6414
NPI assigned
Sep 11, 2012
Last updated
Jun 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0002995 CO Primary

Addresses

Primary practice location

1739 Main St
Longmont, CO 80501-2035

Mailing address

2221 E Bijou St Ste 100
Colorado Springs, CO 80909-8009
Phone (719) 576-1850

Other identifiers 2

IdentifierTypeStateIssuer
1326398967MedicaidCO
OPT.0002995OtherCOCO OPTOMETRY LICENSE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131120001913 CO Practitioner - Optometry 8426284464 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Front Range Eye Health Center, P.C.Group PAC ID 9638060817, 4 clinicians

Practice addresses (Care Compare)

1220 Summit View Dr
Louisville, CO 80027-2572
Phone (303) 665-7797

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0002995COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Eye Care, PC Optometrist CurrentSince Oct 5, 2013 Accepting new patients
Jackson Eyecare, PC Optometrist CurrentSince Oct 5, 2013 Accepting new patients
Mark D. Jackson, OD and Assoc., PC Optometrist Past Accepting new patients

Locations

1037 Robertson St
Fort Collins, CO 80524
Phone (970) 224-0606

Interoperability endpoints

  • Direct secure messaging: apalmerfr@frontrangeeyehealth.emadirect.md

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1326398967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 E BIJOU ST STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809098009",
            "telephone_number": "719-576-1850",
            "fax_number": "719-955-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805012035",
            "telephone_number": "303-834-6400",
            "fax_number": "303-834-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "ANNE-MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0002995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326398967",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO OPTOMETRY LICENSE",
            "identifier": "OPT.0002995",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.