Vital Vision PLLC
Organization Active NPI Optometrist · Bozeman, MT
NPI 1962024125 · NPPES record last updated May 11, 2020
Key facts
- NPI
- 1962024125
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- VITAL VISION PLLC
- Practice address
- 270 W Kagy Blvd Ste B
Bozeman, MT 59715-6055 - Phone
- (406) 404-1666
- Fax
- (406) 404-1885
- NPI assigned
- May 11, 2020
- Organization subpart
- No
Authorized official
- Name
- Eude A Ossorio, CONSULTANT
- Title
- Consultant
- Phone
- (662) 510-2941
Practitioners 3
-
Cody Philip Blom, O.D.
-
Sarah Elizabeth Hill, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200616001668 | MT | Part B Supplier - Clinic/Group Practice | 0941622112 |
Receives reassigned benefits from 3 practitioners Practice locations: Bozeman, MT |
National Provider Directory
Locations
280 W Kagy Blvd
Ste B
Bozeman, MT 59715
Phone (406) 522-8888
270 W Kagy Blvd
Ste B
Bozeman, MT 59715
Phone (406) 404-1375
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
270 W Kagy Blvd Ste B
Bozeman, MT 59715-6055
Mailing address
270 W Kagy Blvd Ste B
Bozeman, MT 59715-6055
Phone (406) 404-1666
Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.