Individual provider Active NPI

Joanne Lew-Goltz, OD

  • Optometrist
  • Durango, CO
National Provider Identifier
1447224969
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2589 Issued in CO
Practice address
1155 S Camino del Rio
Durango, CO 81303-6698
Phone
(970) 385-1935
Fax
(970) 259-8901
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1493 AZ
Optometrist 152W00000X 2589 CO Primary

Addresses

Primary practice location

1155 S Camino del Rio
Durango, CO 81303-6698

Mailing address

PO Box 703
Durango, CO 81302-0703
Phone (415) 845-5699

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
I20070801000867 CO Practitioner - Optometry 0345210217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1155 S Camino del Rio
Eye Care for Durango
Durango, CO 81303-6698
Phone (970) 259-8798

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2589COMDAddiction (Substance Use Disorder) Counselor
1493AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care for Durango, LLC Optometrist CurrentSince Jun 28, 2007 Accepting new patients

Locations

1155 S Camino del Rio
Durango, CO 81303
Phone (970) 259-8788

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1447224969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 703",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813020703",
            "telephone_number": "415-845-5699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 S CAMINO DEL RIO",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813036698",
            "telephone_number": "970-385-1935",
            "fax_number": "970-259-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEW-GOLTZ",
        "first_name": "JOANNE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1493",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.