Boulder Eye Care Professionals LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2540 Issued in CO

Legal business name

BOULDER EYE CARE PROFESSIONALS LLC

Practice address

2795 Pearl St Ste 100
Boulder, CO 80302-3826

Phone

(720) 565-3031

Fax

(303) 444-9488

NPI assigned

Nov 15, 2012

Last updated

Nov 15, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ashlee Elmont, ODNPI 1699836270

Title

Optometrist/Owner

Phone

(303) 907-2603

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ashlee Deann Elmont, OD

  • Optometrist
  • Boulder, CO
  • NPI 1699836270
  Medicare reassignment NPD Authorized official
• Daniela Lozano, O.D.

  • Optometrist
  • Sherman, TX
  • NPI 1730532730
  NPD
• Justin Daniel Deal, O.D.

  • Optometrist
  • Longmont, CO
  • NPI 1134400054
  NPD (past)

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1689918799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2795 PEARL ST STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803023826",
            "telephone_number": "720-565-3031",
            "fax_number": "303-444-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 PEARL ST STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803023826",
            "telephone_number": "720-565-3031",
            "fax_number": "303-444-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER EYE CARE PROFESSIONALS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "ELMONT",
        "authorized_official_first_name": "ASHLEE",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "303-907-2603",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Boulder Endodontics PLLC
• Boulder Eye Surgeons
• Boulder Family Acupuncture LLC
• Boulder Family Medicine, PC
• Boulder Family Practice Clinic
• Boulder Gynecology & Minimally Invasive Surgery

• Optometrist in Boulder, CO
• Providers in Boulder, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.