Individual provider Active NPI

David Michael Kleim, O.D.

  • Optometrist
  • Centennial, CO
National Provider Identifier
1710064308
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0001679 Issued in CO
Practice address
15530 E Broncos Pkwy
Suite 200
Centennial, CO 80112-7111
Phone
(303) 766-2020
Fax
(303) 680-8337
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 991967999 CO
Optometrist 152W00000X OPT.0001679 CO Primary

Addresses

Primary practice location

15530 E Broncos Pkwy
Suite 200
Centennial, CO 80112-7111

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other identifiers 1

IdentifierTypeStateIssuer
08167991MedicaidCO

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
I20120118000144 CO Practitioner - Optometry 7810889409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Colorado PCGroup PAC ID 7113359415, 58 clinicians

Practice addresses (Care Compare)

15530 E Broncos Pkwy
Unit 200
Centennial, CO 80112-7111
Phone (303) 766-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
991967999COMDOptometrist
OPT.0001679COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Colorado PC Optometrist CurrentSince Oct 11, 2021 Accepting new patients
Myeyedr Optometry of Colorado PC Optometrist CurrentSince Oct 11, 2021 Accepting new patients
Myeyedr Optometry of Colorado PC Optometrist Current Accepting new patients

Locations

15530 E Broncos Pkwy
Unit 200
Englewood, CO 80112
Phone (303) 766-2020

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

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 3

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1710064308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15530 E BRONCOS PKWY",
            "address_2": "SUITE 200",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801127111",
            "telephone_number": "303-766-2020",
            "fax_number": "303-680-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIM",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "991967999",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0001679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08167991",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.