Individual provider Active NPI

Vishwa Sheoran

  • Optometrist
  • Fort Carson, CO
National Provider Identifier
1609618693
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0004058 Issued in CO
Practice address
6110 Martinez St
Fort Carson, CO 80913-2048
Phone
(719) 368-4003
NPI assigned
Jun 10, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X OPT.0004058 CO Primary

Addresses

Primary practice location

6110 Martinez St
Fort Carson, CO 80913-2048

Mailing address

6110 Martinez St
Fort Carson, CO 80913-2048

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
I20241001002210 CO Practitioner - Optometry 0042741001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak View Optometry Peterson PLLCGroup PAC ID 9931512589, 2 clinicians

Practice addresses (Care Compare)

1030 E Stewart Ave
Colorado Springs, CO 80914-2900
Phone (719) 900-5005

6110 Martinez St
Fort Carson, CO 80913-2048
Phone (719) 368-4003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peak View Optometry Fort Carson, LLC Optometrist CurrentSince Aug 5, 2024 Accepting new patients
Peak View Optometry North, PLLC Optometrist CurrentSince Aug 5, 2024 Accepting new patients
Peak View Optometry Peterson, PLLC Optometrist CurrentSince Aug 5, 2024 Accepting new patients
Peak View Optometry South, PLLC Optometrist CurrentSince Aug 5, 2024 Accepting new patients

Locations

5885 Barnes Rd
Colorado Springs, CO 80922
Phone (719) 591-3009

8250 Razorback Rd
Colorado Springs, CO 80920
Phone (719) 260-8230

5550 E Woodmen Rd
Colorado Springs, CO 80920
Phone (719) 531-5566

1030 E Stewart Ave
Bldg 20
Colorado Springs, CO 80914
Phone (719) 574-5252

7190 N Academy Blvd
Colorado Springs, CO 80920
Phone (719) 559-2020

353 N Academy Blvd
Colorado Springs, CO 80909
Phone (719) 559-2020

6110 Martinez St
Ft Carson, CO 80913
Phone (719) 368-2446

1030 E Stewart Ave
Bldg 2017
Peterson AFB, CO 80914
Phone (719) 574-5252

Organizations & group practices 4

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": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1609618693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 MARTINEZ ST",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809132048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 MARTINEZ ST",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809132048",
            "telephone_number": "719-368-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEORAN",
        "first_name": "VISHWA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0004058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Carson, CO

Sources for this page

Verify at the official NPI Registry.