Paul William Heersink, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

990 Issued in CO

Practice address

101 Chico CT
Suite B
Monte Vista, CO 81144-1067

Phone

(719) 852-3412

Fax

(719) 852-3345

NPI assigned

Dec 16, 2005

Sex

Male

Sole proprietor

No

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

Illinois College of Optometry at Chicago, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Monte Vista Eye Care Center IncGroup PAC ID 7719163377, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Monte Vista Eye Care Center Inc.

  • Optometrist
  • Monte Vista, CO
  • NPI 1184747230
  Medicare reassignment Care Compare group NPD Authorized official
• Britt a Buckley MD PC

  • Corneal and Contact Management Optometrist
  • Colorado Springs, CO
  • NPI 1417162355
  NPD (past)

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1750367231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CHICO CT",
            "address_2": "SUITE B",
            "city": "MONTE VISTA",
            "state": "CO",
            "postal_code": "811441067",
            "telephone_number": "719-852-3412",
            "fax_number": "719-852-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CHICO CT",
            "address_2": "SUITE B",
            "city": "MONTE VISTA",
            "state": "CO",
            "postal_code": "811441067",
            "telephone_number": "719-852-3412",
            "fax_number": "719-852-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEERSINK",
        "first_name": "PAUL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08009904",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reginaldo Gerard Garcia, PHD
• Stason Michael Gomez
• Camela Gonzales
• Guardians of Hope, PLLC
• Joshua Paul Heersink, OD
• David N Hinkley, O.D.
• Juniper Meadows, LP
• Theresa A. Kaiser-Griffin, MS, RD
• Tim L Kynion, PAC
• Ryan James Lopez, PTA

• Optometrist in Monte Vista, CO
• Providers in Monte Vista, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.