Organization Active NPI

Colorado Eye Associates, P.C.

  • Ophthalmology Physician
  • Colorado Springs, CO
National Provider Identifier
1336117548
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
COLORADO EYE ASSOCIATES, P.C.
Practice address
2920 N Cascade Ave
Colorado Springs, CO 80907-6262
Phone
(719) 636-3937
Fax
(719) 636-2241
NPI assigned
Mar 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tracie McDermott
Title
Manager
Phone
(719) 636-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

2920 N Cascade Ave
Colorado Springs, CO 80907-6262

Mailing address

2920 N Cascade Ave
Colorado Springs, CO 80907-6262
Phone (719) 636-3937

Other identifiers 2

IdentifierTypeStateIssuer
04074084MedicaidCO
CO07408OtherCOBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

2770 N Union Blvd
Ste 240
Colorado Springs, CO 80909
Phone (719) 471-2020

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336117548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 N CASCADE AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076262",
            "telephone_number": "719-636-3937",
            "fax_number": "719-636-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 N CASCADE AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076262",
            "telephone_number": "719-636-3937",
            "fax_number": "719-636-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO EYE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "719-636-3937"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04074084",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "CO07408",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.