Individual provider Active NPI

Lawrence L Jacobs, O.D.

  • Optometrist
  • Highlands Ranch, CO
National Provider Identifier
1689703308
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 1478 Issued in CO
Practice address
8677 S. Quebec St Suite a
Highlands Ranch, CO 80130-3052
Phone
(303) 794-2020
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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 1478 CO Primary

Addresses

Primary practice location

8677 S. Quebec St Suite a
Highlands Ranch, CO 80130-3052

Mailing address

8677 S. Quebec St Suite a
Highlands Ranch, CO 80130-3052
Phone (303) 794-2020

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
I20041115000955 CO Practitioner - Optometry 2264496918 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT 1478COMDOptometrist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1689703308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8677 S. QUEBEC ST SUITE A",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801303052",
            "telephone_number": "303-794-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8677 S. QUEBEC ST SUITE A",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801303052",
            "telephone_number": "303-794-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "LAWRENCE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT 1478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

Verify at the official NPI Registry.