Individual provider Active NPI

Deborah Fitzgerald Roos, O.D.

  • Optometrist
  • Centennial, CO
National Provider Identifier
1437195708
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1821 Issued in CO
Practice address
5555 E Arapahoe Rd
Centennial, CO 80122-2312
Phone
(303) 338-4545
NPI assigned
Jun 22, 2006
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 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 1821 CO Primary

Addresses

Primary practice location

5555 E Arapahoe Rd
Centennial, CO 80122-2312

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other practice location 1

2480 S Downing St Ste 100
Denver, CO 80210-5843
Phone (303) 777-5455

Other identifiers 2

IdentifierTypeStateIssuer
11219646OtherCOCAQH ID
08012810MedicaidCO

Other names 1

  • Dr. Deborah Lynn Fitzgerald Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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
I20050223000393 CO Practitioner - Optometry 1153374723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

2045 N Franklin St
Kaiser Permanente Franklin Medical
Denver, CO 80205-5437
Phone (303) 338-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1821COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Permanente Medical Group, P.C. CurrentSince Jul 15, 2018 Accepting new patients
Repine Vision and Laser Professional LLC Past Accepting new patients
Dennis J O'Connell, DO, PC PastSince Jul 23, 2016 Accepting new patients

Locations

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

2045 N Franklin St
Denver, CO 80205
Phone (303) 764-4666

5555 E Arapahoe Rd
Littleton, CO 80122
Phone (303) 850-2111

Organizations & group practices 3

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1437195708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 E ARAPAHOE RD",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801222312",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2480 S Downing St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802105843",
            "country_code": "US",
            "telephone_number": "303-777-5455",
            "fax_number": "303-777-1175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROOS",
        "first_name": "DEBORAH",
        "middle_name": "FITZGERALD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "11219646",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08012810",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5555 E Arapahoe Rd",
            "city": "Centennial",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801222312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "FITZGERALD",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.