Individual provider Active NPI

Bryce Tanner, OD

  • Optometrist
  • Cortez, CO
National Provider Identifier
1609181148
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2803 Issued in CO
Practice address
140 North Market St
Cortez, CO 81321
Phone
(970) 565-2020
Fax
(970) 565-3632
NPI assigned
Aug 9, 2010
Last updated
Aug 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2803 CO Primary

Addresses

Primary practice location

140 North Market St
Cortez, CO 81321

Mailing address

PO Box 820
Cortez, CO 81321-0820
Phone (970) 565-2020

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
I20110329000911 CO Practitioner - Optometry 9436332442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2423 E Main St
Suite 4
Cortez, CO 81321-4269
Phone (970) 759-9664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2803COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cortez Vision PC Optometrist CurrentSince Mar 15, 2011 Accepting new patients

Locations

140 N Market St
Cortez, CO 81321
Phone (970) 565-2020

2423 E Main St
Ste 4
Cortez, CO 81321
Phone (970) 565-8809

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1609181148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813210820",
            "telephone_number": "970-565-2020",
            "fax_number": "970-565-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 NORTH MARKET ST",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "81321",
            "telephone_number": "970-565-2020",
            "fax_number": "970-565-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "BRYCE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-09",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortez, CO

Sources for this page

Verify at the official NPI Registry.