Individual provider Active NPI

Ryan T. Reid, OD

  • Optometrist
  • Castle Rock, CO
National Provider Identifier
1609189471
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2795 Issued in CO
Practice address
3745 Dacoro LN Ste 100
Castle Rock, CO 80109-2514
Phone
(303) 660-6005
NPI assigned
Jul 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4682 FL
Optometrist 152W00000X 2795 CO Primary

Addresses

Primary practice location

3745 Dacoro LN Ste 100
Castle Rock, CO 80109-2514

Mailing address

3745 Dacoro LN Ste 100
Castle Rock, CO 80109-2514
Phone (303) 660-6005

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
I20110622000128 CO Practitioner - Optometry 1052598471 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sowash Optometry Group, PC Optometrist CurrentSince Mar 15, 2011 Accepting new patients
Sowash Optometry Group PC Optometrist CurrentSince Mar 15, 2011 Accepting new patients

Locations

545 S Broadway
Ste 500
Denver, CO 80209
Phone (720) 570-4338

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

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": "1279670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1609189471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3745 DACORO LN STE 100",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801092514",
            "telephone_number": "303-660-6005",
            "fax_number": "303-660-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 DACORO LN STE 100",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801092514",
            "telephone_number": "303-660-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "RYAN",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-21",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "4682",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

Verify at the official NPI Registry.