| Rocky Mountain Eye Center Inc A Colorado Provider Network | |
|
27 Montebello Rd, Pueblo, CO 81001-1236 | |
| (719) 545-1530 | |
| (719) 545-2899 |
| Full Name | Rocky Mountain Eye Center Inc A Colorado Provider Network |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 27 Montebello Rd, Pueblo, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073567459 | NPI | - | NPPES |
| 200521004 | Other | NM | NEW MEXICO MEDICARE |
| 04009478 | Medicaid | CO | |
| 85432067 | Medicaid | NM | |
| CK7367 | Other | NM | RAILROAD MEDICARE |
| ROK2008 | Other | CO | ANTHEM BCBS |
| CK2008 | Other | CO | MEDICARE |
| CQ2139 | Other | CO | RAILROAD MEDICARE |
| 608439600 | Other | CO | US DEP LABOR WORK COMP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
| Provider Name | Eric E Blom |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1295784916 PECOS PAC ID: 0749219244 Enrollment ID: I20050804001081 |
| Provider Name | Michael E Millsap |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841440690 PECOS PAC ID: 2860539665 Enrollment ID: I20091028000080 |
| Provider Name | Michael W Coatney |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1164473682 PECOS PAC ID: 9638073323 Enrollment ID: I20091124000325 |
| Provider Name | James A. Eickelman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851341267 PECOS PAC ID: 8123142981 Enrollment ID: I20100831000388 |
| Provider Name | Paul D Rastrelli |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1366492480 PECOS PAC ID: 5092758037 Enrollment ID: I20100903000550 |
| Provider Name | Donald A Schlomer |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1700836210 PECOS PAC ID: 7012909310 Enrollment ID: I20100903000612 |
| Provider Name | Joseph Hartman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841499837 PECOS PAC ID: 3678666112 Enrollment ID: I20120215000900 |
| Provider Name | Brandon J Tibbitts |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1902184534 PECOS PAC ID: 4587811856 Enrollment ID: I20120822000403 |
| Provider Name | Heather Kim |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154761765 PECOS PAC ID: 7517100316 Enrollment ID: I20130827000159 |
| Provider Name | David M Brown |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942614813 PECOS PAC ID: 3577781566 Enrollment ID: I20140904002521 |
| Provider Name | Anna J Clark |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376831693 PECOS PAC ID: 3375868532 Enrollment ID: I20150210001428 |
| Provider Name | Nicholas Chariton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427407287 PECOS PAC ID: 7214223056 Enrollment ID: I20160906000249 |
| Provider Name | Nathan R Stevens |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1801873401 PECOS PAC ID: 3072644244 Enrollment ID: I20161110001883 |
| Provider Name | Scott A Butikofer |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184067308 PECOS PAC ID: 3274834916 Enrollment ID: I20170710002406 |
| Provider Name | Brian Stanley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144739608 PECOS PAC ID: 2769893049 Enrollment ID: I20201117001304 |
| Provider Name | Sumana Kommana |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1255782173 PECOS PAC ID: 9436573748 Enrollment ID: I20210715000398 |
| Provider Name | Matthew Newbold |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083283642 PECOS PAC ID: 3274936679 Enrollment ID: I20210722002305 |
| Provider Name | Michael L Streeter |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598334898 PECOS PAC ID: 0840694733 Enrollment ID: I20210816000650 |
| Provider Name | Maximilian Psolka |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1255441952 PECOS PAC ID: 6608921523 Enrollment ID: I20220621001874 |
| Mailing Address | Practice Location Address |
|---|---|
| Rocky Mountain Eye Center Inc A Colorado Provider Network 27 Montebello Rd, Pueblo, CO 81001-1236 Ph: (719) 545-1530 | Rocky Mountain Eye Center Inc A Colorado Provider Network 27 Montebello Rd, Pueblo, CO 81001-1236 Ph: (719) 545-1530 |