Individual provider Active NPI

Michael E Luby, OD

  • Optometrist
  • Grand Junction, CO
National Provider Identifier
1366555161
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1035 Issued in CO
Practice address
1000 Wellington Ave
Grand Junction, CO 81501
Phone
(970) 243-9000
Fax
(970) 245-4936
NPI assigned
Aug 16, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1035 CO Primary

Addresses

Primary practice location

1000 Wellington Ave
Grand Junction, CO 81501

Mailing address

2460 Patterson Rd Unit 2
Grand Junction, CO 81505-1027
Phone (970) 243-9000

Other identifiers 1

IdentifierTypeStateIssuer
08010357MedicaidCO

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
I20100914000640 CO Practitioner - Optometry 2163547126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Rockies Eye Center PCGroup PAC ID 4183513757, 3 clinicians

Practice addresses (Care Compare)

2460 Patterson Rd
Unit 2
Grand Junction, CO 81505-1027
Phone (970) 243-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1035COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Rockies Eye Center PC CurrentSince Apr 15, 1997 Accepting new patients

Locations

1000 Wellington Ave
Grand Junction, CO 81501
Phone (970) 243-9000

2460 Patterson Rd
Unit 2
Grand Junction, CO 81505
Phone (970) 243-9000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1366555161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 PATTERSON RD UNIT 2",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051027",
            "telephone_number": "970-243-9000",
            "fax_number": "970-245-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WELLINGTON AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "81501",
            "telephone_number": "970-243-9000",
            "fax_number": "970-245-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUBY",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08010357",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.