Organization Active NPI

Martin Vision PC

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1710947098
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1784 Issued in CO
Legal business name
MARTIN VISION PC
Doing business as
Impressive Eyes Optical
Martin Vision PC
Practice address
388 Main St
Colorado Springs, CO 80911-1713
Phone
(719) 391-2000
Fax
(844) 273-2910
NPI assigned
Mar 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Authorized official

Name
Cynthia Martin, ODNPI 1649439241
Title
Owner
Phone
(719) 660-2162

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 1784 CO Primary

Addresses

Primary practice location

388 Main St
Colorado Springs, CO 80911-1713

Mailing address

13505 Herring Rd
Colorado Springs, CO 80908-2946
Phone (719) 282-8555

Other identifiers 2

IdentifierTypeStateIssuer
99382041MedicaidCO
06002242MedicaidCO

Other names 2

  • Impressive Eyes Optical Doing business as
  • Martin Vision PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110331000033 CO Part B Supplier - Clinic/Group Practice 7618150517 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

388 Main St
Colorado Springs, CO 80911
Phone (719) 210-1200

Practitioners & affiliated clinicians

Practitioners 3

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": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1710947098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13505 HERRING RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809082946",
            "telephone_number": "719-282-8555",
            "fax_number": "718-282-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 MAIN ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809111713",
            "telephone_number": "719-391-2000",
            "fax_number": "844-273-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN VISION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-660-2162",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99382041",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06002242",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Impressive Eyes Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Martin Vision PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Martin Vision PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.