Individual provider Active NPI

Kenneth Quan Phi, O.D.

  • Optometrist
  • Denver, CO
National Provider Identifier
1770979940
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003285 Issued in CO
Practice address
2795 S Colorado Blvd
Denver, CO 80222-6601
Phone
(303) 782-0470
NPI assigned
Apr 14, 2015
Last updated
May 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 15149 CA
Optometrist 152W00000X OPT.0003285 CO Primary

Addresses

Primary practice location

2795 S Colorado Blvd
Denver, CO 80222-6601

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

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
I20170525000160 CO Practitioner - Optometry 3476853615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Colorado PCGroup PAC ID 7113359415, 58 clinicians

Practice addresses (Care Compare)

1550 S Potomac St
Suite 155
Aurora, CO 80012-5444
Phone (303) 369-1020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Colorado PC Optometrist CurrentSince Oct 13, 2019 Accepting new patients
Myeyedr Optometry of Colorado PC Optometrist Current Accepting new patients
Myeyedr Optometry of Colorado PC Optometrist CurrentSince Oct 13, 2019 Accepting new patients

Locations

1550 S Potomac St
Ste 155
Aurora, CO 80012
Phone (303) 369-1020

2795 S Colorado Blvd
Denver, CO 80222
Phone (303) 782-0470

200 W County Line Rd
Ste 150
Highlands Ranch, CO 80129
Phone (303) 794-2433

2766 S Wadsworth Blvd
Lakewood, CO 80227
Phone (303) 935-2020

10521 S Parker Rd
Parker, CO 80134
Phone (303) 841-8243

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1770979940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 S COLORADO BLVD",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802226601",
            "telephone_number": "303-782-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHI",
        "first_name": "KENNETH",
        "middle_name": "QUAN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-14",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "15149",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.