Marisa Perez-Wilson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2581 Issued in CO

Practice address

13605 Xavier LN
Suite G @ the Chateaux
Broomfield, CO 80023-3603

Phone

(303) 951-1820

Fax

(303) 951-1826

NPI assigned

Jul 27, 2007

Last updated

May 2, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Marisa Perez Professional name

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

Specialty

Optometry

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Front Range Eye Associates PCGroup PAC ID 0446253652, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drperez@frea.direct.kno2fy.com

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.

• Front Range Eye Associates, PC

  • Optometrist
  • Broomfield, CO
  • NPI 1760418156
  Medicare reassignment Care Compare group NPD
• Children's Eye Physicians P.C.

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Boulder, CO
  • NPI 1336758184
  NPD (past)

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1346430238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13605 XAVIER LN",
            "address_2": "SUITE G @ THE CHATEAUX",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800233603",
            "telephone_number": "303-951-1820",
            "fax_number": "303-951-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13605 XAVIER LN",
            "address_2": "SUITE G @ THE CHATEAUX",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800233603",
            "telephone_number": "303-951-1820",
            "fax_number": "303-951-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-WILSON",
        "first_name": "MARISA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2581",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "4192",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "PEREZ",
            "prefix": "DR.",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mary Jayne Pedersen, RN. BSN.
• Mary Elizabeth Peebles, DDS
• Andrew James Pelle, DO
• Karen Percival, PT
• Victoria Pereira, NCTMB
• Perfect Teeth - West 120TH Avenue P.C.
• Stephanie Lynn Perri, LPC
• Susan K. Peters, MS, LPC
• Debra Jean Petersen, NP
• Derek Gene Petersen, D.D.S.

• Optometrist in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.