Individual provider Active NPI

Matthew J Skrdla, O.D.

  • Optometrist
  • Fort Collins, CO
National Provider Identifier
1750377172
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2197 Issued in CO
Practice address
300 E Foothills Pkwy
Ste B
Fort Collins, CO 80525-2613
Phone
(970) 282-7739
Fax
(970) 226-6654
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2197 CO Primary

Addresses

Primary practice location

300 E Foothills Pkwy
Ste B
Fort Collins, CO 80525-2613

Mailing address

300 E Foothills Pkwy
Ste B
Fort Collins, CO 80525-2613
Phone (970) 282-7739

Other identifiers 1

IdentifierTypeStateIssuer
66574854MedicaidCO

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
I20041117000430 CO Practitioner - Optometry 1355305871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
One Hour Optical Medical Services, PCGroup PAC ID 4880662485, 42 clinicians

Practice addresses (Care Compare)

1685 S Co Blvd
Unit O
Denver, CO 80222-4011
Phone (303) 757-6747

712 Whalers Way
Suite A210
Fort Collins, CO 80525-3621
Phone (970) 282-7739

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2197COMDOptometrist

Organizations & group practices 1

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1750377172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E FOOTHILLS PKWY",
            "address_2": "STE B",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252613",
            "telephone_number": "970-282-7739",
            "fax_number": "970-226-6654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E FOOTHILLS PKWY",
            "address_2": "STE B",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252613",
            "telephone_number": "970-282-7739",
            "fax_number": "970-226-6654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKRDLA",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "66574854",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.