Individual provider Active NPI

Craig T. Eckroth, O.D.

  • Optometrist
  • Craig, CO
National Provider Identifier
1821142332
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1589 Issued in CO
Practice address
1111 W Victory Way
Suite 110
Craig, CO 81625-2950
Phone
(970) 824-3488
Fax
(970) 824-8132
NPI assigned
Jan 22, 2007
Last updated
Sep 5, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1589 CO Primary

Addresses

Primary practice location

1111 W Victory Way
Suite 110
Craig, CO 81625-2950

Mailing address

1111 W Victory Way
Suite 110
Craig, CO 81625-2950
Phone (970) 824-3488

Other identifiers 2

IdentifierTypeStateIssuer
410041337OtherCOPALMETTO RR MEDICARE
08015893MedicaidCO

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
I20080813000209 CO Practitioner - Optometry 0446325328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecare Specialties IncGroup PAC ID 3678898111, 2 clinicians

Practice addresses (Care Compare)

460 Pershing St
Suite 100
Craig, CO 81625-2954

Merit-based Incentive Payment System (MIPS)

Final score
67.63 of 100Reported as individual
Quality
35.26
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery60

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1589COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecare Specialties Inc. Optometrist CurrentSince Aug 18, 2024 Accepting new patients
Eyecare Specialties Inc. Optometrist CurrentSince Jan 1, 2015 Accepting new patients

Locations

1111 W Victory Way
Ste 110
Craig, CO 81625
Phone (870) 824-3488

460 Pershing St
Ste 100
Craig, CO 81625
Phone (435) 637-7860

Interoperability endpoints

  • Direct secure messaging: direct@eyecarespecialtiescraigco.compulinkdirect.com

Organizations & group practices 2

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1821142332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W VICTORY WAY",
            "address_2": "SUITE 110",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816252950",
            "telephone_number": "970-824-3488",
            "fax_number": "970-824-8132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W VICTORY WAY",
            "address_2": "SUITE 110",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816252950",
            "telephone_number": "970-824-3488",
            "fax_number": "970-824-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKROTH",
        "first_name": "CRAIG",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "410041337",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08015893",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Craig, CO

Sources for this page

Verify at the official NPI Registry.