Individual provider Active NPI

Marcia Schulte Stauter, O.D.

  • Optometrist
  • Greeley, CO
National Provider Identifier
1821188749
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1282 Issued in CO
Practice address
3545 W 12TH St
Ste. 101
Greeley, CO 80634-2545
Phone
(970) 352-4200
Fax
(970) 352-4278
NPI assigned
Oct 13, 2006
Last updated
Apr 16, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 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 1282 CO Primary

Addresses

Primary practice location

3545 W 12TH St
Ste. 101
Greeley, CO 80634-2545

Mailing address

3545 W 12TH St
Ste. 101
Greeley, CO 80634-2545
Phone (970) 352-4200

Other identifiers 1

IdentifierTypeStateIssuer
08012825MedicaidCO

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
I20050922001108 CO Practitioner - Optometry 1658305255 Reassigns benefits to 1 organization
Practice locations: Greeley, CO

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Associates of Co LLCGroup PAC ID 9537597828, 63 clinicians

Practice addresses (Care Compare)

3545 W 12TH St
Suite 101
Greeley, CO 80634-2545
Phone (970) 352-4200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates of Co LLC Optometrist CurrentSince Apr 5, 2021 Accepting new patients
Eye Care Associates of Co LLC Optometrist CurrentSince Apr 5, 2021 Accepting new patients

Locations

3545 W 12th St
Ste 101
Greeley, CO 80634
Phone (970) 352-4200

8925 Ridgeline Blvd
Ste 107
Highlands Ranch, CO 80129
Phone (303) 791-2727

412 Main St
Longmont, CO 80501
Phone (303) 651-6700

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1821188749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 W 12TH ST",
            "address_2": "STE. 101",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342545",
            "telephone_number": "970-352-4200",
            "fax_number": "970-352-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 W 12TH ST",
            "address_2": "STE. 101",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342545",
            "telephone_number": "970-352-4200",
            "fax_number": "970-352-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUTER",
        "first_name": "MARCIA",
        "middle_name": "SCHULTE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "1282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08012825",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.