Individual provider Active NPI

Deanna Monique Pedroza, O.D.

  • Optometrist
  • Thornton, CO
National Provider Identifier
1740412121
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2737 Issued in CO
Practice address
550 Thornton Pkwy
Suite # 222
Thornton, CO 80229-2100
Phone
(303) 920-3937
Fax
(719) 542-0425
NPI assigned
Aug 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2737 CO Primary

Addresses

Primary practice location

550 Thornton Pkwy
Suite # 222
Thornton, CO 80229-2100

Mailing address

13142 Grant Cir N
Unit B
Thornton, CO 80241-3498
Phone (720) 217-7644

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
I20091009000189 CO Practitioner - Optometry 1557407293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Vista Eye Care, PCGroup PAC ID 8123152113, 9 clinicians

Practice addresses (Care Compare)

13695 Colorado Blvd
Thornton, CO 80602-7051
Phone (303) 450-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2737COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Eye Care, PC Optometrist CurrentSince Apr 18, 2010 Accepting new patients
Vision & Eye Health Associates Optometrist Past Accepting new patients
Bright Eyes Vision Clinic PC a Colorado Professional Corporation Optometrist PastSince Nov 8, 2020 Accepting new patients

Locations

13695 Colorado Blvd
Thornton, CO 80602
Phone (303) 450-2020

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": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1740412121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13142 GRANT CIR N",
            "address_2": "UNIT B",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802413498",
            "telephone_number": "720-217-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 THORNTON PKWY",
            "address_2": "SUITE # 222",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802292100",
            "telephone_number": "303-920-3937",
            "fax_number": "719-542-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDROZA",
        "first_name": "DEANNA",
        "middle_name": "MONIQUE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-18",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.