Individual provider Active NPI

Lisa Jordan, O.D.

  • Optometrist
  • Broomfield, CO
National Provider Identifier
1669453320
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2125 Issued in CO
Practice address
4 Garden Ctr
Ste 100
Broomfield, CO 80020-7026
Phone
(303) 469-1941
Fax
(303) 469-6634
NPI assigned
Nov 9, 2005
Last updated
Jun 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 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 2125 CO Primary

Addresses

Primary practice location

4 Garden Ctr
Ste 100
Broomfield, CO 80020-7026

Mailing address

4 Garden Ctr
Ste 100
Broomfield, CO 80020-7026
Phone (303) 469-1941

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
I20051117000381 CO Practitioner - Optometry 6800815952 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Colorado PCGroup PAC ID 7113359415, 58 clinicians
Colorado Eye Center, LLCGroup PAC ID 7012805328, 7 clinicians

Practice addresses (Care Compare)

10001 Washington St
Suite 1
Thornton, CO 80229-2031
Phone (303) 451-8075

200 W County Line Rd
Suite 150
Highlands Ranch, CO 80129-2361
Phone (303) 794-2433

4 Garden Ctr
Suite 100
Broomfield, CO 80020-7090
Phone (303) 469-1941

Merit-based Incentive Payment System (MIPS)

Final score
89.07 of 100Reported as group
Quality
87.67
Improvement activities
40
Cost
80

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2125COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Eye Center, LLC Optometrist Current Accepting new patients
Colorado Eye Center, LLC Optometrist CurrentSince Jan 3, 2010 Accepting new patients
Madison Street Provider Network Inc Optometrist CurrentSince Feb 1, 2020 Accepting new patients
Madison Street Provider Network Inc CurrentSince Feb 1, 2020 Accepting new patients
Colorado Eye Center, LLC Optometrist CurrentSince Jan 3, 2010 Accepting new patients
Myeyedr Optometry of Colorado PC Optometrist Past Accepting new patients

Locations

4 Garden Ctr
Ste 100
Broomfield, CO 80020
Phone (303) 469-1941

55 Madison St
Ste 355
Denver, CO 80206
Phone (303) 398-7320

125 Inverness Dr E
Ste 200
Englewood, CO 80112
Phone (303) 708-8234

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: lisa.jordan.d1.p5@direct.inlandeyespecialists.nextgenshare.com
  • Direct secure messaging: lisa.jordan.p1@direct.inlandeyespecialists.nextgenshare.com

Organizations & group practices 6

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1669453320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GARDEN CTR",
            "address_2": "STE 100",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207026",
            "telephone_number": "303-469-1941",
            "fax_number": "303-469-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GARDEN CTR",
            "address_2": "STE 100",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207026",
            "telephone_number": "303-469-1941",
            "fax_number": "303-469-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "LISA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.