Active NPI
Samuel Jeng, M.D., P.C.
- Ophthalmology Physician
- Greeley, CO
National Provider Identifier
1821356163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 49343
- Legal business name
- SAMUEL JENG, M.D., P.C.
- Practice address
- 1616 15TH St
Greeley, CO 80631-4571 - Phone
- (970) 352-6688
- Fax
- (970) 353-2892
- NPI assigned
- Apr 24, 2012
- Last updated
- Apr 24, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Samuel M Jeng, M.D.
- Title
- Physician/Owner
- Phone
- (970) 352-6688
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 49343 | CO | Primary |
Addresses
Primary practice location
1616 15TH St
Greeley, CO 80631-4571
Mailing address
1616 15TH St
Greeley, CO 80631-4571
Phone (970) 352-6688
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64474283 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO, WY
Enrollment records 2
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 7
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.
-
- Ophthalmology Physician
- Greeley, CO
- NPI 1902211105
-
- Optometrist
- Greeley, CO
- NPI 1649014523
-
- Optometrist
- Eaton, CO
- NPI 1942516646
-
- Surgery Physician
- Fort Morgan, CO
- NPI 1174668388
-
- Optometrist
- Fort Morgan, CO
- NPI 1225287444
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335225600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1335225600000",
"number": "1821356163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1616 15TH ST",
"city": "GREELEY",
"state": "CO",
"postal_code": "806314571",
"telephone_number": "970-352-6688",
"fax_number": "970-353-2892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 15TH ST",
"city": "GREELEY",
"state": "CO",
"postal_code": "806314571",
"telephone_number": "970-352-6688",
"fax_number": "970-353-2892"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAMUEL JENG, M.D., P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2012-04-24",
"last_updated": "2012-04-24",
"status": "A",
"authorized_official_last_name": "JENG",
"authorized_official_first_name": "SAMUEL",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PHYSICIAN/OWNER",
"authorized_official_telephone_number": "970-352-6688",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CO",
"license": "49343",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64474283",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; 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.