Active NPI
Mike Blechacz
- Optometrist
- Lakewood, CO
National Provider Identifier
1376718429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2527
- Practice address
- 959 S Miller St
#202
Lakewood, CO 80226-3927 - Phone
- (303) 716-5831
- NPI assigned
- Apr 29, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2527 | CO | Primary |
| Optometrist | 152W00000X | 2701 | WI |
Addresses
Primary practice location
959 S Miller St
#202
Lakewood, CO 80226-3927
Mailing address
959 S Miller St
#202
Lakewood, CO 80226-3927
Phone (303) 716-5831
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2527 | CO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jan'S Optical LLC | Optometrist | Past | Accepting new patients |
| Janet S White | Optometrist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Optometrist
- Waupun, WI
- NPI 1053759340
-
- Optometrist
- Waupun, WI
- NPI 1326143157
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209427200000",
"number": "1376718429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "959 S MILLER ST",
"address_2": "#202",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802263927",
"telephone_number": "303-716-5831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "959 S MILLER ST",
"address_2": "#202",
"city": "LAKEWOOD",
"state": "CO",
"postal_code": "802263927",
"telephone_number": "303-716-5831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLECHACZ",
"first_name": "MIKE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-29",
"last_updated": "2008-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "2527",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "2701",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.