NPIMap

Organization Active NPI

Madison Street Provider Network Inc

Doing business as Omni Eye Specialists

  • Ophthalmology Physician
  • Brighton, CO
National Provider Identifier
1750988994
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MADISON STREET PROVIDER NETWORK INC
Doing business as
Omni Eye Specialists
Practice address
203 Telluride St Unit 900
Brighton, CO 80601-4369
Phone
(303) 377-2020
NPI assigned
Oct 1, 2020
Last updated
Aug 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MADISON STREET PROVIDER NETWORK INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Authorized official

Name
George L Neal
Title
President
Phone
(469) 214-0144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

203 Telluride St Unit 900
Brighton, CO 80601-4369

Mailing address

PO Box 912914
Denver, CO 80291-2914

Other practice location 1

606 South 4th Ave
Marchus CHiropractic Medical Office
Brighton, CO 80601-3202
Phone (303) 377-6349

Other names 1

  • Omni Eye Specialists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051109000347 CO Part B Supplier - Clinic/Group Practice 5193742948 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Westminster, CO; Golden, CO; Fort Collins, CO; Englewood, CO; Denver, CO; Aurora, CO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Madison Street Provider Network Inc

Locations

606 S 4th Ave
Ofc
Brighton, CO 80601
Phone (303) 377-6349

2109 N Frontage Rd W
Ste B
Vail, CO 81657
Phone (970) 476-3670

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1750988994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912914",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802912914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 TELLURIDE ST UNIT 900",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806014369",
            "telephone_number": "303-377-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "606 South 4th Ave",
            "address_2": "Marchus CHiropractic Medical Office",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "CO",
            "postal_code": "806013202",
            "country_code": "US",
            "telephone_number": "303-377-6349",
            "fax_number": "303-377-2022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MADISON STREET PROVIDER NETWORK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MADISON STREET PROVIDER NETWORK INC",
        "enumeration_date": "2020-10-01",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-214-0144"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omni Eye Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Omni Eye Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brighton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.