Individual provider Active NPI

Wesley D Cooper, OD

  • Optometrist
  • Montrose, CO
National Provider Identifier
1841290319
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
716 Issued in CO
Practice address
400 S Nevada Ave
Montrose, CO 81401-5738
Phone
(970) 249-3914
Fax
(970) 249-7893
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 716 CO Primary

Addresses

Primary practice location

400 S Nevada Ave
Montrose, CO 81401-5738

Mailing address

400 S Nevada Ave
Montrose, CO 81401-5738
Phone (970) 249-3914

Other identifiers 2

IdentifierTypeStateIssuer
1841290319OtherNPI
08765232MedicaidCO

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
I20060118000107 CO Practitioner - Optometry 5193749125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1965
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 S Nevada Ave
Montrose, CO 81401-5738
Phone (970) 249-3914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
716COMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Wesley D. Cooper, Optometrist, P.C. Optometrist CurrentSince Jan 14, 2000 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

400 S Nevada Ave
Montrose, CO 81401
Phone (970) 249-3914

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1841290319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S NEVADA AVE",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015738",
            "telephone_number": "970-249-3914",
            "fax_number": "970-249-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S NEVADA AVE",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015738",
            "telephone_number": "970-249-3914",
            "fax_number": "970-249-7893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "WESLEY",
        "middle_name": "D",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841290319",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08765232",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

Verify at the official NPI Registry.