Individual provider Active NPI

Amanda Pisha, OD

  • Optometrist
  • Denver, CO
National Provider Identifier
1548413040
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2655 Issued in CO
Practice address
1400 Grove St
Denver, CO 80204-2229
Phone
(303) 824-2295
Fax
(303) 824-2244
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2655 CO Primary

Addresses

Primary practice location

1400 Grove St
Denver, CO 80204-2229

Mailing address

1400 Grove St
Denver, CO 80204-2229
Phone (303) 825-2295

Other identifiers 2

IdentifierTypeStateIssuer
80909736MedicaidCO
OPT.0002655OtherCOCO OPTOMETRY LICENSE

Other names 1

  • Amanda Haney Former name

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
I20130710000005 CO Practitioner - Optometry 8921248295 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2655COMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sowash Optometry Group, PC Optometrist CurrentSince Oct 12, 2020 Accepting new patients
Sowash Optometry Group PC Optometrist CurrentSince Oct 12, 2020 Accepting new patients

Locations

6252 S Central St
Aurora, CO 80016
Phone (303) 693-0333

4206 N Freeway Rd
Pueblo, CO 81008
Phone (719) 253-2538

Organizations & group practices 2

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": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1548413040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 GROVE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802042229",
            "telephone_number": "303-825-2295",
            "fax_number": "303-824-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 GROVE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802042229",
            "telephone_number": "303-824-2295",
            "fax_number": "303-824-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISHA",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80909736",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO OPTOMETRY LICENSE",
            "identifier": "OPT.0002655",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "HANEY",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.