| Carbon Valley Eye Care | |
|
5900 Keyes St Ste 101, Frederick, CO 80504-5956 | |
| (303) 833-1056 | |
| (303) 833-1057 |
| Full Name | Carbon Valley Eye Care |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 5900 Keyes St Ste 101, Frederick, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235558065 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 2850 (Colorado) | Primary |
| Provider Name | Michael Edward Koditek |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1366735201 PECOS PAC ID: 1951562784 Enrollment ID: I20120423000056 |
| Provider Name | Taylor Kiyota Jackson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275158404 PECOS PAC ID: 7315361839 Enrollment ID: I20200716003074 |
| Provider Name | Michael A Bagley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114380482 PECOS PAC ID: 1355767369 Enrollment ID: I20201023000020 |
| Provider Name | Yessica G Canas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447829916 PECOS PAC ID: 7517368368 Enrollment ID: I20210630001928 |
| Provider Name | Matthew A Winkler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1578842274 PECOS PAC ID: 4183891898 Enrollment ID: I20231209000022 |
| Mailing Address | Practice Location Address |
|---|---|
| Carbon Valley Eye Care 5900 Keyes St Ste 101, Frederick, CO 80504-5956 Ph: (303) 833-1056 | Carbon Valley Eye Care 5900 Keyes St Ste 101, Frederick, CO 80504-5956 Ph: (303) 833-1056 |
Dr. Michael Andrew Bagley, OD Optometrist Medicare: Medicare Enrolled Practice Location: 5900 Keyes St Ste 101, Frederick, CO 80504 Phone: 303-833-1056 | |
Taylor Kiyota Jackson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 5900 Keyes St Ste 101, Frederick, CO 80504 Phone: 303-833-1056 | |
Mr. Michael Edward Koditek, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 5900 Keyes St Ste 101, Frederick, CO 80504 Phone: 303-833-1056 Fax: 303-833-1057 | |
Dr. Jeffrey Berger, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 5900 Keyes St Ste 101, Frederick, CO 80504 Phone: 303-833-1056 |