Individual provider Active NPI

Frederick James Hurlbut Jr., OD

  • Optometrist
  • Denver, CO
National Provider Identifier
1417912635
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1069 Issued in CO
Practice address
1573 S Colorado Blvd
Denver, CO 80222-3704
Phone
(303) 782-0470
Fax
(303) 782-0474
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1069 CO Primary

Addresses

Primary practice location

1573 S Colorado Blvd
Denver, CO 80222-3704

Mailing address

942 S Cove Way
Denver, CO 80209-5110
Phone (303) 744-6264

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
I20041209000474 CO Practitioner - Optometry 3577529692 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1069COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Colorado PC Optometrist CurrentSince Oct 11, 2019 Accepting new patients
Myeyedr Optometry of Colorado PC Optometrist CurrentSince Oct 11, 2019 Accepting new patients
Myeyedr Optometry of Colorado PC Optometrist Current Accepting new patients
A.T. Eyes PC Optometrist Past Accepting new patients

Locations

2795 S Colorado Blvd
Denver, CO 80222
Phone (303) 782-0470

200 W County Line Rd
Ste 150
Highlands Ranch, CO 80129
Phone (303) 794-2433

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417912635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 S COVE WAY",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802095110",
            "telephone_number": "303-744-6264",
            "fax_number": "303-765-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1573 S COLORADO BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802223704",
            "telephone_number": "303-782-0470",
            "fax_number": "303-782-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLBUT",
        "first_name": "FREDERICK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.