Provider Demographics
NPI:1316091523
Name:METROWEST EYE ASSOCIATES, P.C.
Entity type:Organization
Organization Name:METROWEST EYE ASSOCIATES, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:TROY
Authorized Official - Last Name:ORTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-688-5066
Mailing Address - Street 1:250 MAX DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-9517
Mailing Address - Country:US
Mailing Address - Phone:303-688-5066
Mailing Address - Fax:303-688-6986
Practice Address - Street 1:250 MAX DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CASTLE PINES
Practice Address - State:CO
Practice Address - Zip Code:80108-9517
Practice Address - Country:US
Practice Address - Phone:303-688-5066
Practice Address - Fax:303-688-6986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2238152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO803358Medicare UPIN
CO803357Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
COV06639Medicare UPIN