Rachel Amelia Potter, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-2591 Issued in CO

Practice address

2080 Main St
Longmont, CO 80501-1916

Phone

(303) 651-2020

Fax

(303) 776-2460

NPI assigned

Jul 5, 2007

Last updated

Jun 17, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optometric Associates PCGroup PAC ID 0345131033, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Optometric Associates PC

  dba Eagle Vision & Eye Clinic PC

  • Optometrist
  • Longmont, CO
  • NPI 1730299116
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1730387374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 PRINCE CIR",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805167536",
            "telephone_number": "303-945-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 MAIN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011916",
            "telephone_number": "303-651-2020",
            "fax_number": "303-776-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "RACHEL",
        "middle_name": "AMELIA",
        "name_prefix": "Miss",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT-2591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85605590",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Portillo, RN
• Allison Kathleen Portillo, MA
• Melanie Potock, MA, CCC-SLP
• Douglas Kenji Potter, R.PH.
• Phillip Adam Potter, MA, BCBA
• Poudre Valley Medical Group, LLC (UCHealth Medical Group)
• Poudre Valley Medical Group, LLC (UCHealth Medical Group)
• Poudre Valley Medical Group, LLC
• Poudre Valley Medical Group, LLC (UCHealth Medical Group)
• Poudre Valley Medical Group, LLC (UCHealth Medical Group)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.