Individual provider Active NPI

Jeffrey Craig Marlatt, OD

  • Optometrist
  • Lonetree, CO
National Provider Identifier
1902807332
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2038 Issued in CO
Practice address
9400 Station St
Suite 150
Lonetree, CO 80124-6808
Phone
(303) 925-0075
Fax
(303) 925-0079
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2038 CO Primary
Corneal and Contact Management Optometrist 152WC0802X 2038 CO

Addresses

Primary practice location

9400 Station St
Suite 150
Lonetree, CO 80124-6808

Mailing address

9400 Station St
Suite 150
Lonetree, CO 80124-6808
Phone (303) 925-0075

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
I20050112000379 CO Practitioner - Optometry 1557319472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkridge Vision Specialists PC 3 clinicians

Practice addresses (Care Compare)

9400 Station St
Suite 150
Lone Tree, CO 80124-6815
Phone (303) 925-0075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2038COMDClinical Social Worker

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1902807332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 STATION ST",
            "address_2": "SUITE 150",
            "city": "LONETREE",
            "state": "CO",
            "postal_code": "801246808",
            "telephone_number": "303-925-0075",
            "fax_number": "303-925-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 STATION ST",
            "address_2": "SUITE 150",
            "city": "LONETREE",
            "state": "CO",
            "postal_code": "801246808",
            "telephone_number": "303-925-0075",
            "fax_number": "303-925-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLATT",
        "first_name": "JEFFREY",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2038",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "CO",
            "license": "2038",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lonetree, CO

Sources for this page

Verify at the official NPI Registry.