NPIMap

Organization Active NPI

Colorado Eye Center, LLC

Doing business as Great Vision Eye Care

  • Optometrist
  • Broomfield, CO
National Provider Identifier
1366516825
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
COLORADO EYE CENTER, LLC
Doing business as
Great Vision Eye Care
Sunrise Vision Center
Practice address
4 Garden Ctr Ste 100
Broomfield, CO 80020-7090
Phone
(303) 469-1941
Fax
(303) 469-6634
NPI assigned
Nov 17, 2006
Last updated
Feb 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
Mr. George Neal
Title
Chief Executive Officer
Phone
(844) 377-6468

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Optometrist 152W00000X NU Primary
Ophthalmology Physician 207W00000X NU

Addresses

Primary practice location

4 Garden Ctr Ste 100
Broomfield, CO 80020-7090

Mailing address

4 Garden Center
Ste 100
Broomfield, CO 80020-7090
Phone (303) 469-1941

Other practice location 1

9835 S Parker Rd
Parker, CO 80134-8815
Phone (303) 841-3937

Other practice location 2

1485 S Colorado Blvd Ste 220
Denver, CO 80222-3640
Phone (303) 839-7878

Other practice location 3

1692 30th St
Boulder, CO 80301-1034
Phone (303) 449-0857

Other practice location 4

12450 York St
Thornton, CO 80241-2741
Phone (303) 452-2020

Other practice location 5

10001 N Washington
Thornton, CO 80229-2050
Phone (303) 451-8075

Other practice location 6

1371 Hecla Dr Ste C
Louisville, CO 80027-2318
Phone (303) 666-7226

Other names 2

  • Great Vision Eye Care Doing business as
  • Sunrise Vision Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309000069 CO Part B Supplier - Clinic/Group Practice 7012805328 Receives reassigned benefits from 14 practitioners
4 other NPIs on this enrollment
Practice locations: Thorton, CO; Thornton, CO; Broomfield, CO; Boulder, CO; Parker, CO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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

Locations

1371 Hecla Dr
Ste C
Louisville, CO 80027
Phone (303) 666-7226

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1366516825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GARDEN CENTER",
            "address_2": "STE 100",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207090",
            "telephone_number": "303-469-1941",
            "fax_number": "303-469-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GARDEN CTR STE 100",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207090",
            "telephone_number": "303-469-1941",
            "fax_number": "303-469-6634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9835 S Parker Rd",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801348815",
            "country_code": "US",
            "telephone_number": "303-841-3937",
            "fax_number": "303-444-6560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1485 S Colorado Blvd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802223640",
            "country_code": "US",
            "telephone_number": "303-839-7878",
            "fax_number": "303-759-9975",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1692 30th St",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803011034",
            "country_code": "US",
            "telephone_number": "303-449-0857",
            "fax_number": "303-444-6560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12450 York St",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802412741",
            "country_code": "US",
            "telephone_number": "303-452-2020",
            "fax_number": "303-452-0934",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10001 N Washington",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "802292050",
            "country_code": "US",
            "telephone_number": "303-451-8075",
            "fax_number": "303-457-9859",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1371 Hecla Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "CO",
            "postal_code": "800272318",
            "country_code": "US",
            "telephone_number": "303-666-7226",
            "fax_number": "303-666-3367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLORADO EYE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "844-377-6468",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Vision Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sunrise Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.