NPIMap

Organization Active NPI

Children's Eye Physicians P.C.

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Boulder, CO
National Provider Identifier
1336758184
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
Legal business name
CHILDREN'S EYE PHYSICIANS P.C.
Practice address
2575 Pearl St Ste 1C
Boulder, CO 80302-3851
Phone
(303) 456-9456
Fax
(303) 467-0145
NPI assigned
Jul 28, 2020
Last updated
Sep 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Authorized official

Name
Lynette M Bridges
Title
Ceo
Phone
(303) 456-9456

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X NU
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X NU Primary

Addresses

Primary practice location

2575 Pearl St Ste 1C
Boulder, CO 80302-3851

Mailing address

4875 Ward Rd Ste 600
Wheat Ridge, CO 80033-1944
Phone (303) 456-9456

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324000766 CO Part B Supplier - Clinic/Group Practice 5890686158 Receives reassigned benefits from 19 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boulder, CO; Centennial, CO; Denver, CO; Erie, CO; Grand Junction, CO; Wheat Ridge, CO

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Robert a King MD7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

13605 Xavier Ln
Ste G
Broomfield, CO 80023
Phone (303) 951-1820

9094 E Mineral Cir
Ste 200
Centennial, CO 80112
Phone (303) 488-0000

2400 Village Vista Dr
Erie, CO 80516

4045 Wadsworth Blvd
Ste 111
Wheat Ridge, CO 80033

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599177600000",
    "number": "1336758184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4875 WARD RD STE 600",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800331944",
            "telephone_number": "303-456-9456",
            "fax_number": "303-463-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 PEARL ST STE 1C",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803023851",
            "telephone_number": "303-456-9456",
            "fax_number": "303-467-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S EYE PHYSICIANS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "303-456-9456"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.