Individual provider Active NPI

Alaina Jacobsen, OD

  • Optometrist
  • Longmont, CO
National Provider Identifier
1801570288
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0004006 Issued in CO
Practice address
205 S Main St Ste D
Longmont, CO 80501-1714
Phone
(303) 772-3611
NPI assigned
Jun 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OPT.0004006 CO Primary

Addresses

Primary practice location

205 S Main St Ste D
Longmont, CO 80501-1714

Mailing address

205 S Main St Ste D
Longmont, CO 80501-1714
Phone (303) 772-3611

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
I20240827000673 CO Practitioner - Optometry 9335688068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Front Range Eye Physicians PCGroup PAC ID 2567615248, 3 clinicians

Practice addresses (Care Compare)

205 S Main St
Suite D
Longmont, CO 80501-1714
Phone (303) 772-3611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.0004006COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Front Range Eye Physicians PC Multi-Specialty CurrentSince Aug 26, 2024 Accepting new patients

Locations

205 S Main St
Ste D
Longmont, CO 80501
Phone (303) 772-3611

Interoperability endpoints

  • Direct secure messaging: ajacobsenod@frontrangeeye.direct.eyemdemr.com

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": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1801570288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S MAIN ST STE D",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011714",
            "telephone_number": "303-772-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S MAIN ST STE D",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805011714",
            "telephone_number": "303-772-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "ALAINA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0004006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.