Individual provider Active NPI

William Rex Eland, O.D.

  • Optometrist
  • Berthoud, CO
National Provider Identifier
1811088495
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-1026 Issued in CO
Practice address
1211 Lake Ave Ste 102
Berthoud, CO 80513-9381
Phone
(970) 532-5605
Fax
(970) 532-5607
NPI assigned
Sep 27, 2006
Last updated
Feb 21, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-1026 CO Primary

Addresses

Primary practice location

1211 Lake Ave Ste 102
Berthoud, CO 80513-9381

Mailing address

1211 Lake Ave Ste 102
Berthoud, CO 80513-9381
Phone (970) 532-5605

Other identifiers 1

IdentifierTypeStateIssuer
63821371MedicaidCO

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
I20040721001682 CO Practitioner - Optometry 9133109044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WM Rex Eland OD PCGroup PAC ID 1557307436, 2 clinicians

Practice addresses (Care Compare)

1211 Ake Ave
Suite 102
Berthoud, CO 80513-9381
Phone (970) 532-5605

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-1026COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
WM. Rex Eland, O.D., P.C. Optometrist CurrentSince Jun 1, 2005 Accepting new patients
Ronald L Mearsha OD PC Optometrist Past Accepting new patients
Colorado Urgent Care PLLC PastSince Aug 2, 2020 Accepting new patients
Colorado Vision Center P C Optometrist Past Accepting new patients
Edie Bowman OD LLC Optometrist Past Accepting new patients

Locations

1211 Lake Ave
Ste 102
Berthoud, CO 80513
Phone (970) 532-5605

Organizations & group practices 5

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1811088495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 LAKE AVE STE 102",
            "city": "BERTHOUD",
            "state": "CO",
            "postal_code": "805139381",
            "telephone_number": "970-532-5605",
            "fax_number": "970-532-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 LAKE AVE STE 102",
            "city": "BERTHOUD",
            "state": "CO",
            "postal_code": "805139381",
            "telephone_number": "970-532-5605",
            "fax_number": "970-532-5607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELAND",
        "first_name": "WILLIAM",
        "middle_name": "REX",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT-1026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63821371",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berthoud, CO

Sources for this page

Verify at the official NPI Registry.