Individual provider Active NPI

Garrett Moen, O.D.

  • Optometrist
  • Castle Rock, CO
National Provider Identifier
1629458930
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003156 Issued in CO
Practice address
1001 S Perry St Ste 101B
Castle Rock, CO 80104-1921
Phone
(303) 337-2020
Fax
(303) 337-2053
NPI assigned
Jun 2, 2015
Last updated
Jun 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 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 OPT.0003156 CO Primary

Addresses

Primary practice location

1001 S Perry St Ste 101B
Castle Rock, CO 80104-1921

Mailing address

1001 S Perry St Ste 101B
Castle Rock, CO 80104-1921
Phone (303) 337-2020

Other identifiers 1

IdentifierTypeStateIssuer
1467957746MedicaidCO

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
I20180226001039 CO Practitioner - Optometry 0446511950 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elevation Vision OD PLLCGroup PAC ID 4284988015, 2 clinicians

Practice addresses (Care Compare)

1001 S Perry St
Suite 101B
Castle Rock, CO 80104-1921
Phone (303) 337-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3156COMDClinical Psychologist
OPT.0003156COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Elevation Vision OD PLLC Optometrist CurrentSince Aug 1, 2018 Accepting new patients
Abba Eye Care PC Optometrist CurrentSince Sep 30, 2020 Accepting new patients
Abba Eye Care PC Optometrist CurrentSince Sep 30, 2020 Accepting new patients

Locations

2101 Main St
Ste D
Alamosa, CO 81101
Phone (719) 589-2020

1001 S Perry St
Ste 101B
Castle Rock, CO 80104
Phone (303) 688-2228

658 Genoa Way
Ste B
Castle Rock, CO 80109
Phone (303) 337-2020

1130 Lake Plaza Dr
Ste 130
Colorado Springs, CO 80906
Phone (719) 578-2020

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, 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": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1629458930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S PERRY ST STE 101B",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041921",
            "telephone_number": "303-337-2020",
            "fax_number": "303-337-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S PERRY ST STE 101B",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041921",
            "telephone_number": "303-337-2020",
            "fax_number": "303-337-2053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEN",
        "first_name": "GARRETT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467957746",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

Verify at the official NPI Registry.