Individual provider Active NPI

Thanh Le, O.D.

  • Optometrist
  • Highlands Ranch, CO
National Provider Identifier
1902152473
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003476 Issued in CO
Practice address
1265 SGT Jon Stiles Dr
Highlands Ranch, CO 80129-2263
Phone
(303) 791-1984
Fax
(303) 683-5560
NPI assigned
Aug 1, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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.0003476 CO Primary

Addresses

Primary practice location

1265 SGT Jon Stiles Dr
Highlands Ranch, CO 80129-2263

Mailing address

PO Box 630147
Littleton, CO 80163-0147
Phone (708) 833-0711

Other identifiers 1

IdentifierTypeStateIssuer
OPT.0003476OtherCOCO OPTOMETRY LICENSE

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
I20240614002175 CO Practitioner - Optometry 6608208996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1265 SGT Jon Stiles Dr
Highlands Ranch, CO 80129-2263
Phone (303) 791-1984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Eyecare P.C. Optometrist CurrentSince Jul 1, 2024 Accepting new patients

Locations

1265 Sgt Jon Stiles Dr
Highlands Ranch, CO 80129
Phone (303) 323-4972

Organizations & group practices 1

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": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1902152473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630147",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801630147",
            "telephone_number": "708-833-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 SGT JON STILES DR",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801292263",
            "telephone_number": "303-791-1984",
            "fax_number": "303-683-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "THANH",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-01",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO OPTOMETRY LICENSE",
            "identifier": "OPT.0003476",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands Ranch, CO

Sources for this page

Verify at the official NPI Registry.