Active NPI
Myeyedr Optometry of Colorado PC
- Optometrist
- Boulder, CO
National Provider Identifier
1861154585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- MYEYEDR OPTOMETRY OF COLORADO PC
- Practice address
- 2449 Pine St
Boulder, CO 80302-4610 - Phone
- (720) 600-0440
- Fax
- (720) 403-8628
- NPI assigned
- Oct 11, 2021
- 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
- Sue Downes
- Title
- Secretary
- Phone
- (703) 847-8899
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
2449 Pine St
Boulder, CO 80302-4610
Mailing address
8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899
Other names 1
- MyEyeDr.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
Other NPIs on the same Medicare enrollment 30
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Usaf Academy, CO
- NPI 1033412341
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1653264000000",
"number": "1861154585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8614 WESTWOOD CENTER DR FL 9",
"city": "VIENNA",
"state": "VA",
"postal_code": "221822442",
"telephone_number": "703-847-8899",
"fax_number": "571-223-6780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2449 PINE ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803024610",
"telephone_number": "720-600-0440",
"fax_number": "720-403-8628"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MYEYEDR OPTOMETRY OF COLORADO PC",
"organizational_subpart": "NO",
"enumeration_date": "2021-10-11",
"last_updated": "2022-05-23",
"certification_date": "2022-05-23",
"status": "A",
"authorized_official_last_name": "DOWNES",
"authorized_official_first_name": "SUE",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "703-847-8899"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MyEyeDr.",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "MyEyeDr.",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.