NPIMap

Organization Active NPI

Archuleta Eyecare Associates, LLC

  • Optometrist
  • Pagosa Springs, CO
National Provider Identifier
1649205113
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2532 Issued in CO
Legal business name
ARCHULETA EYECARE ASSOCIATES, LLC
Practice address
190 Talisman Dr Unit B4
Pagosa Springs, CO 81147-9171
Phone
(970) 731-4347
NPI assigned
Jul 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Authorized official

Name
Dr. Jonathan Zissman, O.D.NPI 1396770962
Title
Owner
Phone
(970) 713-4347

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2532 CO Primary

Addresses

Primary practice location

190 Talisman Dr Unit B4
Pagosa Springs, CO 81147-9171

Mailing address

190 Talisman Dr Unit B4
Pagosa Springs, CO 81147-9171
Phone (505) 263-4695

Other names 1

  • Mountian Eye Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060927000255 CO Part B Supplier - Clinic/Group Practice 4587669437 Receives reassigned benefits from 2 practitioners
Practice locations: Pagosa Springs, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631059200000",
    "number": "1649205113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 TALISMAN DR UNIT B4",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811479171",
            "telephone_number": "505-263-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 TALISMAN DR UNIT B4",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811479171",
            "telephone_number": "970-731-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHULETA EYECARE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "ZISSMAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-713-4347",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountian Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountian Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pagosa Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.