Organization Active NPI

Eyecare Associates, P.C.

  • Optometrist
  • Fort Collins, CO
National Provider Identifier
1457566143
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYECARE ASSOCIATES, P.C.
Practice address
702 W Drake Rd BLDG B
Fort Collins, CO 80526-5563
Phone
(970) 221-4811
Fax
(970) 221-4815
NPI assigned
May 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Authorized official

Name
Dr. Deanna Alexander, ODNPI 1346304813
Title
President
Phone
(970) 221-4811

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

702 W Drake Rd BLDG B
Fort Collins, CO 80526-5563

Mailing address

702 W Drake Rd BLDG B
Fort Collins, CO 80526-5563
Phone (970) 221-4811

Other identifiers 1

IdentifierTypeStateIssuer
04011664MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040322001328 CO Part B Supplier - Clinic/Group Practice 1254222037 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Fort Collins, CO
O20100930036784 CO DME Supplier - Physician - OptometristDME Supplier - Optician 1254222037 Practice locations: Fort Collins, CO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2080562Eyecare Associates, PC702 West Drake Road, BLDG B, Fort Collins, CO 80526Certificate of waiverJul 9, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Eyecare Associates PC702 W Drake Rd, Fort Collins, CO 80526-5526(970) 221-4811 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

702 W Drake Rd
Bldg B
Fort Collins, CO 80526
Phone (970) 221-4811

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657238400000",
    "number": "1457566143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 W DRAKE RD BLDG B",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805265563",
            "telephone_number": "970-221-4811",
            "fax_number": "970-221-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W DRAKE RD BLDG B",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805265563",
            "telephone_number": "970-221-4811",
            "fax_number": "970-221-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-221-4811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04011664",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.