Individual provider Active NPI

Chad Ellis Nicholson, O.D.

  • Optometrist
  • Aurora, CO
National Provider Identifier
1366487829
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2131 Issued in CO
Practice address
6290 S Main St
Suite 100
Aurora, CO 80016-5322
Phone
(303) 766-0545
Fax
(303) 766-0624
NPI assigned
Jun 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2131 CO Primary

Addresses

Primary practice location

6290 S Main St
Suite 100
Aurora, CO 80016-5322

Mailing address

6290 S Main St
Ste 100
Aurora, CO 80016-5379
Phone (303) 766-0545

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
I20060906000167 CO Practitioner - Optometry 6002810009 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southlands Vision AssociatesGroup PAC ID 6709880792, 5 clinicians
Altitude Eye Care at Castlerock PLLCGroup PAC ID 4688092711, 4 clinicians
Altitude Eye CareGroup PAC ID 2365778065, 6 clinicians

Practice addresses (Care Compare)

6290 S Main St
Suite 100
Aurora, CO 80016-5379
Phone (303) 766-0545

6380 Promenade Pkwy
Suite a 100
Castle Rock, CO 80108-1909
Phone (720) 475-9991

8405 Park Meadows Ctr Dr
Suite 1000
Lone Tree, CO 80124-5025
Phone (303) 649-9500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2131COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southlands Vision Associates Optometrist CurrentSince Oct 1, 2006 Accepting new patients
Altitude Eye Care at Castlerock, PLLC Optometrist CurrentSince Aug 24, 2020 Accepting new patients
Altitude Eye Care Optometrist CurrentSince Jun 17, 2019 Accepting new patients

Locations

6290 S Main St
Ste 100
Aurora, CO 80016
Phone (303) 766-0545

6380 Promenade Pkwy
Unit 100
Castle Rock, CO 80108
Phone (720) 475-9989

6380 Promenade Pkwy
Ste A100
Castle Rock, CO 80108
Phone (720) 475-9991

8405 Park Meadows Center Dr
Ste 1000
Lone Tree, CO 80124
Phone (303) 649-9500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1366487829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6290 S MAIN ST",
            "address_2": "STE 100",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165379",
            "telephone_number": "303-766-0545",
            "fax_number": "303-766-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6290 S MAIN ST",
            "address_2": "SUITE 100",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165322",
            "telephone_number": "303-766-0545",
            "fax_number": "303-766-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "CHAD",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.