NPIMap

Organization Active NPI

Arvada Eyecare LLC

  • Optometrist
  • Arvada, CO
National Provider Identifier
1497856017
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1507 Issued in CO
Legal business name
ARVADA EYECARE LLC
Practice address
16205 W 64TH Ave
#100
Arvada, CO 80007-7401
Phone
(303) 424-2991
Fax
(303) 467-2486
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Authorized official

Name
Mansur Nurdel, OD
Title
President
Phone
(303) 424-2991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1507 CO Primary

Addresses

Primary practice location

16205 W 64TH Ave
#100
Arvada, CO 80007-7401

Mailing address

16205 W 64TH Ave
#100
Arvada, CO 80007-7401
Phone (303) 424-2991

Other identifiers 1

IdentifierTypeStateIssuer
04403771MedicaidCO

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040501000290 CO Part B Supplier - Clinic/Group Practice 5092703975 Receives reassigned benefits from 8 practitioners
Practice locations: Arvada, CO
O20100930095205 CO DME Supplier - Physician - OptometristDME Supplier - Optician 5092703975 Practice locations: Arvada, CO

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Arvada Eyecare16205 W 64TH Ave, Arvada, CO 80007-7401(303) 424-2991 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since May 1, 2004

National Provider Directory

National Provider Directory

Locations

12308 W 64th Ave
Arvada, CO 80004
Phone (303) 424-2991

Practitioners & affiliated clinicians

Practitioners 9

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": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1497856017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16205 W 64TH AVE",
            "address_2": "#100",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800077401",
            "telephone_number": "303-424-2991",
            "fax_number": "303-467-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16205 W 64TH AVE",
            "address_2": "#100",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800077401",
            "telephone_number": "303-424-2991",
            "fax_number": "303-467-2486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARVADA EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "NURDEL",
        "authorized_official_first_name": "MANSUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-424-2991",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04403771",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.