Individual provider Active NPI

Jennifer Slebos Redmond, O.D.

  • Optometrist
  • Aurora, CO
National Provider Identifier
1629078019
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2055 Issued in CO
Practice address
24200 E Smoky Hill Rd
Aurora, CO 80016-1381
Phone
(720) 870-2828
Fax
(720) 870-2117
NPI assigned
Jul 28, 2005
Last updated
Dec 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2055 CO Primary

Addresses

Primary practice location

24200 E Smoky Hill Rd
Aurora, CO 80016-1381

Mailing address

24200 E Smoky Hill Rd
Aurora, CO 80016-1381
Phone (720) 870-2828

Other identifiers 1

IdentifierTypeStateIssuer
C450498OtherCOPTAN

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
I20100730000712 CO Practitioner - Optometry 4688707417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jeri a Schneebeck, OD, PCGroup PAC ID 4385547496, 5 clinicians

Practice addresses (Care Compare)

24200 E Smoky Hill Rd
Aurora, CO 80016-1381
Phone (720) 870-2828

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2055COMDClinical Psychologist

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1629078019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24200 E SMOKY HILL RD",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800161381",
            "telephone_number": "720-870-2828",
            "fax_number": "720-870-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24200 E SMOKY HILL RD",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800161381",
            "telephone_number": "720-870-2828",
            "fax_number": "720-870-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDMOND",
        "first_name": "JENNIFER",
        "middle_name": "SLEBOS",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "C450498",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.