NPIMap

Organization Active NPI

Boulder Vision Associates, P.C., Inc.

  • Optometrist
  • Boulder, CO
National Provider Identifier
1437346343
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1436 Issued in CO
Legal business name
BOULDER VISION ASSOCIATES, P.C., INC.
Practice address
5305 Spine Rd Ste B
Boulder, CO 80301-3331
Phone
(303) 530-2020
NPI assigned
Sep 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Authorized official

Name
Paige Michelle Paddock, O.D.NPI 1013027291
Title
Vice-President
Phone
(303) 530-2020

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 2534 CO
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 1436 CO Primary

Addresses

Primary practice location

5305 Spine Rd Ste B
Boulder, CO 80301-3331

Mailing address

5305 Spine Rd Ste B
Boulder, CO 80301-3331
Phone (303) 530-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081112000643 CO Part B Supplier - Clinic/Group Practice 7113086661 Receives reassigned benefits from 1 practitioner
Practice locations: Boulder, CO

National Provider Directory

National Provider Directory

Locations

5365 Spine Rd
Ste B
Boulder, CO 80301
Phone (303) 530-2020

5305 Spine Rd
Ste B
Boulder, CO 80301
Phone (303) 530-2020

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1437346343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 SPINE RD STE B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013331",
            "telephone_number": "303-530-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 SPINE RD STE B",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013331",
            "telephone_number": "303-530-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER VISION ASSOCIATES, P.C., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "PADDOCK",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "303-530-2020",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2534",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.