Domenic Cozzetta, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3530 Issued in CO

Practice address

1620 Fortino Blvd
Pueblo, CO 81008-1856

Phone

(719) 542-3555

NPI assigned

Aug 27, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Colorado Eye Care Associates PCGroup PAC ID 7214055672, 4 clinicians

Bright Eyes Vision Clinic PC a Colorado Professional CorporationGroup PAC ID 7113813106, 10 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bright Eyes Vision Clinic PC a Colorado Professional Corporation

  • Optometrist
  • Canon City, CO
  • NPI 1679525208
  Medicare reassignment Care Compare group NPD
• Southern Colorado Eye Care Associates PC

  • Optometrist
  • Pueblo, CO
  • NPI 1679744841
  Medicare reassignment Care Compare group NPD
• Southern Colorado Eye Care

  • Optometrist
  • Pueblo West, CO
  • NPI 1376983924
  Medicare reassignment NPD

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1881242592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 FORTINO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081856",
            "telephone_number": "719-542-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 FORTINO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081856",
            "telephone_number": "719-542-3555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "326 Dozier Ave",
            "address_purpose": "LOCATION",
            "city": "Canon City",
            "state": "CO",
            "postal_code": "812122706",
            "country_code": "US",
            "telephone_number": "719-276-0344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COZZETTA",
        "first_name": "DOMENIC",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "3530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cover Family Dental
• Felicia Elizabeth Cover, LPCC
• Hannah Grace Cowles
• Fred Arthur Cox, D.O.
• William Slade Cox, PHARMD
• Michael R. Cozzetta, O.D.
• Carlee Craig, LMT
• Kristi Blasingame Craig, DDS
• Lisa T Cramer, M.D.
• Maria Ann Cramer, LCSW

• Optometrist in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.