Organization Active NPI

Professional Vision Care, P.C.

  • Optometrist
  • Denver, CO
National Provider Identifier
1376974790
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2939 Issued in CO
Legal business name
PROFESSIONAL VISION CARE, P.C.
Practice address
1580 Blake St
Denver, CO 80202-1322
Phone
(303) 844-3937
Fax
(303) 844-3940
NPI assigned
Dec 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Authorized official

Name
Marie Schaefer, O.D.NPI 1386927861
Title
President
Phone
(701) 540-2307

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 2939 CO Primary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 2978 CO

Addresses

Primary practice location

1580 Blake St
Denver, CO 80202-1322

Mailing address

1580 Blake St
Denver, CO 80202-1322
Phone (303) 844-3937

Other names 1

  • Optique of Denver Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150205001283 CO Part B Supplier - Clinic/Group Practice 5395060776 Receives reassigned benefits from 6 practitioners
Practice locations: Denver, CO

National Provider Directory

National Provider Directory
Tax ID family
Optique of Denver2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1525 15th St
Denver, CO 80202
Phone (303) 844-3937

1632 S Broadway
Denver, CO 80210
Phone (303) 844-3937

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386720000000",
    "number": "1376974790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 BLAKE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021322",
            "telephone_number": "303-844-3937",
            "fax_number": "303-844-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 BLAKE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802021322",
            "telephone_number": "303-844-3937",
            "fax_number": "303-844-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL VISION CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-11",
        "last_updated": "2013-12-11",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-540-2307",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2939",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optique of Denver",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.