Active NPI
Scott Noal Gunderson, O.D.
- Optometrist
- Broomfield, CO
National Provider Identifier
1861620098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2733
- Practice address
- 5760 W 120TH Ave
Suite 240
Broomfield, CO 80020-6942 - Phone
- (303) 951-1820
- Fax
- (303) 951-1826
- NPI assigned
- Jun 25, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2733 | CO | Primary |
Addresses
Primary practice location
5760 W 120TH Ave
Suite 240
Broomfield, CO 80020-6942
Mailing address
3454 Molly LN
Broomfield, CO 80023-4519
Phone (801) 836-5350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2733 | CO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Front Range Eye Associates, PC | Optometrist | Past | Accepting new patients |
| Children's Eye Physicians P.C. | Past | Accepting new patients |
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.
-
- Pediatric Ophthalmology and Strabismus Specialist Physician
- Boulder, CO
- NPI 1336758184
-
- Optometrist
- Broomfield, CO
- NPI 1760418156
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245888000000",
"number": "1861620098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3454 MOLLY LN",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800234519",
"telephone_number": "801-836-5350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5760 W 120TH AVE",
"address_2": "SUITE 240",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800206942",
"telephone_number": "303-951-1820",
"fax_number": "303-951-1826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNDERSON",
"first_name": "SCOTT",
"middle_name": "NOAL",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-25",
"last_updated": "2009-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "2733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.