Organization Active NPI

Mile High Senior Eyecare LLC

  • Optometrist
  • Lone Tree, CO
National Provider Identifier
1386351864
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MILE HIGH SENIOR EYECARE LLC
Practice address
10416 Lynx Run
Lone Tree, CO 80124-9536
Phone
(720) 819-5594
NPI assigned
Nov 3, 2022
Last updated
Nov 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Authorized official

Name
Dr. Jessica Schuman, ODNPI 1619259348
Title
Optometrist/Owner
Phone
(720) 819-5594

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

10416 Lynx Run
Lone Tree, CO 80124-9536

Mailing address

10416 Lynx Run
Lone Tree, CO 80124-9536

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221206000547 CO Part B Supplier - Clinic/Group Practice 4183093610 Receives reassigned benefits from 1 practitioner
Practice locations: Lone Tree, CO

National Provider Directory

National Provider Directory

Locations

8200 S Quebec St
Ste A3110
Centennial, CO 80112

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667433600000",
    "number": "1386351864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10416 LYNX RUN",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801249536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10416 LYNX RUN",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801249536",
            "telephone_number": "720-819-5594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILE HIGH SENIOR EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A",
        "authorized_official_last_name": "SCHUMAN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "720-819-5594",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.