Individual provider Active NPI

Jena Wolf, OD

  • Optometrist
  • Brighton, CO
National Provider Identifier
1396256889
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003382 Issued in CO
Practice address
193 S 27TH Ave Ste 400
Brighton, CO 80601-2662
Phone
(303) 654-7933
NPI assigned
Oct 24, 2017
Last updated
Apr 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.0003382 CO Primary

Addresses

Primary practice location

193 S 27TH Ave Ste 400
Brighton, CO 80601-2662

Mailing address

125 Goff Ave Unit 5204
Pawtucket, RI 02860-9201

Other identifiers 1

IdentifierTypeStateIssuer
3382OtherCOCOLORADO OPTOMETRIC LISENCE

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
I20180807001831 CO Practitioner - Optometry 0749538874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wolf, OD PCGroup PAC ID 0840425914, 2 clinicians

Practice addresses (Care Compare)

193 S 27TH Ave
Suite 400
Brighton, CO 80601-2662
Phone 303654793312

193 S 27TH St
Suite 400
Brighton, CO 80601-2662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.0003382COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wolf, OD PC Optometrist CurrentSince Jul 9, 2018 Accepting new patients

Locations

193 S 27th Ave
Brighton, CO 80601
Phone (303) 654-7933

193 S 27th Ave
Ste 400
Brighton, CO 80601
Phone (303) 654-7933

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": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1396256889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 GOFF AVE UNIT 5204",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028609201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 S 27TH AVE STE 400",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012662",
            "telephone_number": "303-654-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "JENA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-24",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO OPTOMETRIC LISENCE",
            "identifier": "3382",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, CO

Sources for this page

Verify at the official NPI Registry.