Active NPI
Sanda Win, O.D.
- Optometrist
- Pueblo, CO
National Provider Identifier
1346664877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT.0003418
- Practice address
- 1725 S Pueblo Blvd
Pueblo, CO 81005-2103 - Phone
- (719) 281-2633
- Fax
- (719) 281-2634
- NPI assigned
- Feb 4, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT.0003418 | CO | Primary |
Addresses
Primary practice location
1725 S Pueblo Blvd
Pueblo, CO 81005-2103
Mailing address
2221 E Bijou St Ste 100
Colorado Springs, CO 80909-8009
Phone (719) 576-1850
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OPT.0003418 | Other | CO | CO OPTOMETRY LICENSE |
| 1346664877 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT.0003418 | CO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye Love Care Inc | Optometrist | Past | Accepting new patients |
| Eye Love Care Inc | Optometrist | Past | Accepting new patients |
| Eye Love Care Inc | Optometrist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Optometrist
- Colorado Springs, CO
- NPI 1114525680
-
- Optometrist
- Colorado Springs, CO
- NPI 1265031322
-
- Optometrist
- Colorado Springs, CO
- NPI 1881256147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560297600000",
"number": "1346664877",
"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": "1725 S PUEBLO BLVD",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810052103",
"telephone_number": "719-281-2633",
"fax_number": "719-281-2634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIN",
"first_name": "SANDA",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-04",
"last_updated": "2019-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "OPT.0003418",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CO OPTOMETRY LICENSE",
"identifier": "OPT.0003418",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1346664877",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.