Individual provider Active NPI

Wills Vanray, OD

  • Optometrist
  • Dillon, CO
National Provider Identifier
1508940065
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2708 Issued in CO
Practice address
325 Lake Dillon Drive, Suite 104
Dillon, CO 80435-2804
Phone
(970) 468-0389
Fax
(970) 468-4790
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 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 2708 CO Primary

Addresses

Primary practice location

325 Lake Dillon Drive, Suite 104
Dillon, CO 80435-2804

Mailing address

PO Box 2804
Dillon, CO 80435-2804
Phone (970) 468-0389

Other identifiers 3

IdentifierTypeStateIssuer
83357033MedicaidNM
149736MedicaidAZ
31528546MedicaidCO

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
I20140911000405 CO Practitioner - Optometry 1355340670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

325 Lake Dillon Dr
Suite 104
Dillon, CO 80435-5509
Phone (970) 468-0389

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2708COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Gallup Indian Medical Center Past Accepting new patients
Britt a Buckley MD PC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1508940065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2804",
            "city": "DILLON",
            "state": "CO",
            "postal_code": "804352804",
            "telephone_number": "970-468-0389",
            "fax_number": "970-468-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 LAKE DILLON DRIVE, SUITE 104",
            "city": "DILLON",
            "state": "CO",
            "postal_code": "804352804",
            "telephone_number": "970-468-0389",
            "fax_number": "970-468-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANRAY",
        "first_name": "WILLS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83357033",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149736",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31528546",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dillon, CO

Sources for this page

Verify at the official NPI Registry.