NPIMap

Organization Active NPI

Abba Eye Care PC

  • Optometrist
  • Colorado Springs, CO
National Provider Identifier
1992919419
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ABBA EYE CARE PC
Practice address
1813 N Circle Dr
Colorado Springs, CO 80909-2410
Phone
(719) 632-2020
Fax
(719) 630-0467
NPI assigned
May 10, 2007
Last updated
Nov 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Authorized official

Name
Cathy L Short
Title
Credentialing Manager
Phone
(618) 462-9818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

1813 N Circle Dr
Colorado Springs, CO 80909-2410

Mailing address

1130 Lake Plaza Dr
Colorado Springs, CO 80906-3594
Phone (719) 219-3819

Other identifiers 1

IdentifierTypeStateIssuer
04015491MedicaidCO

National Provider Directory

National Provider Directory

Locations

1130 Lake Plaza Dr
Ste 130
Colorado Springs, CO 80906
Phone (719) 578-2020

1847 S Nevada Ave
Colorado Springs, CO 80905
Phone (719) 578-2020

4430 N Nevada Ave
Colorado Springs, CO 80907
Phone (719) 635-2020

420 N Main St
Gunnison, CO 81230
Phone (719) 641-2020

102 Santa Fe Ave
La Junta, CO 81050
Phone (719) 384-2020

314 Colorado Ave
La Junta, CO 81050
Phone (303) 544-8331

1500 S Main St
Lamar, CO 81052
Phone (719) 336-0417

1501 Court St
Pueblo, CO 81003
Phone (719) 543-6755

Practitioners & affiliated clinicians

Practitioners 94

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 94

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604448000000",
    "number": "1992919419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 LAKE PLAZA DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063594",
            "telephone_number": "719-219-3819",
            "fax_number": "719-219-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 N CIRCLE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809092410",
            "telephone_number": "719-632-2020",
            "fax_number": "719-630-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBA EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "618-462-9818"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04015491",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.