Staci Perea McMullen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2151 Issued in CO

Practice address

6071 E Woodmen Rd
Suite 205
Colorado Springs, CO 80923-2607

Phone

(719) 380-6808

Fax

(719) 380-5656

NPI assigned

Sep 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Chapel Hills Vision P C

  • Optometrist
  • Colorado Springs, CO
  • NPI 1639164973

  I20100909000944

  Same enrollment

Specialty

Optometry

Education

Pacific University - College of Optometry, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain View Vision PCGroup PAC ID 9830282797, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smcmullen@mvvision.eyefinity-direct.com

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.

• Mountain View Vision, PC

  dba Mountain View Vision

  • Optometrist
  • Colorado Springs, CO
  • NPI 1942408737
  Medicare reassignment Care Compare group NPD
• Chapel Hills Vision P C

  • Optometrist
  • Colorado Springs, CO
  • NPI 1639164973
  NPD

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1386639615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6071 E WOODMEN RD",
            "address_2": "SUITE 205",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809232607",
            "telephone_number": "719-380-6808",
            "fax_number": "719-380-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 E WOODMEN RD",
            "address_2": "SUITE 205",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809232607",
            "telephone_number": "719-380-6808",
            "fax_number": "719-380-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "STACI",
        "middle_name": "PEREA",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88427811",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Christine McMillen, CAA
• Miracle McMillian
• Alyssa Rae McMinn, DPT
• Craig Thomas McMullen, MD
• Richard Bard McMullen, M.D.
• Brianna Rachelle McMurray, DO
• Desiree McMurtrey-Perryman
• Farran McNabb
• Kevin Laverne McNabb, P.A.
• James McNair

• Optometrist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.