Individual provider Active NPI

Sandra Noemi Pinon, O.D.

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1861947327
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003368 Issued in CO
Practice address
2436 S Academy Blvd
Colorado Springs, CO 80916-2408
Phone
(719) 391-2336
Fax
(719) 391-1625
NPI assigned
Aug 24, 2016
Last updated
Jun 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.0003368 CO Primary

Addresses

Primary practice location

2436 S Academy Blvd
Colorado Springs, CO 80916-2408

Mailing address

2221 E Bijou St Ste 100
Colorado Springs, CO 80909-8009
Phone (719) 576-1850

Other identifiers 2

IdentifierTypeStateIssuer
OPT.0003368OtherCOCO OPTOMETRY LICENSE
1861947327MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170418001142 TX Practitioner - Optometry 9931485422 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.0003368COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Michael R. Castro & Associates, PLLC Optometrist CurrentSince May 1, 2020 Accepting new patients
Nielsen Vision Development Center CurrentSince Jun 1, 2020 Accepting new patients
Keith Dennis OD PA Optometrist CurrentSince Feb 15, 2017 Accepting new patients

Locations

1928 State Highway 46 W
Ste 110
New Braunfels, TX 78132
Phone (210) 507-7979

3107 S Interstate 35
Ste 780B
Round Rock, TX 78664
Phone (512) 248-2020

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": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1861947327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 E BIJOU ST STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809098009",
            "telephone_number": "719-576-1850",
            "fax_number": "719-955-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2436 S ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162408",
            "telephone_number": "719-391-2336",
            "fax_number": "719-391-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINON",
        "first_name": "SANDRA",
        "middle_name": "NOEMI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO OPTOMETRY LICENSE",
            "identifier": "OPT.0003368",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861947327",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.