NPIMap

Organization Active NPI

Eye Center of Northern Colorado, P.C

Doing business as Boulder Eye Surgeons PC

  • Ophthalmology Physician
  • Boulder, CO
National Provider Identifier
1790806644
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYE CENTER OF NORTHERN COLORADO, P.C
Doing business as
Boulder Eye Surgeons PC
Practice address
4745 Arapahoe Ave
Suite 100
Boulder, CO 80303-1080
Phone
(303) 444-3000
Fax
(303) 444-3226
NPI assigned
Apr 2, 2007
Last updated
Feb 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Authorized official

Name
Dr. Brian Nichols, M.D. PH.D.NPI 1699727172
Title
Secretary
Phone
(303) 444-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

4745 Arapahoe Ave
Suite 100
Boulder, CO 80303-1080

Mailing address

4745 Arapahoe Ave
Suite 100
Boulder, CO 80303-1080
Phone (303) 444-3000

Other names 1

  • Boulder Eye Surgeons PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040923001240 CO Part B Supplier - Clinic/Group Practice 3274501481 Receives reassigned benefits from 10 practitioners
2 other NPIs on this enrollment
Practice locations: Erie, CO; Boulder, CO

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Donald J Keller MD PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1790806644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 ARAPAHOE AVE",
            "address_2": "SUITE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031080",
            "telephone_number": "303-444-3000",
            "fax_number": "303-444-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 ARAPAHOE AVE",
            "address_2": "SUITE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031080",
            "telephone_number": "303-444-3000",
            "fax_number": "303-444-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CENTER OF NORTHERN COLORADO, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "303-444-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D. PH.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boulder Eye Surgeons PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Boulder Eye Surgeons PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.