Provider Demographics
NPI:1457406498
Name:JAMES A. SIMONSON, O.D., P.C.
Entity Type:Organization
Organization Name:JAMES A. SIMONSON, O.D., P.C.
Other - Org Name:DR. JAMES A. SIMONSON & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SIMONSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-649-9500
Mailing Address - Street 1:8405 PARK MEADOWS CENTER DRIVE
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5025
Mailing Address - Country:US
Mailing Address - Phone:303-649-9500
Mailing Address - Fax:303-706-9062
Practice Address - Street 1:8405 PARK MEADOWS CENTER DRIVE
Practice Address - Street 2:SUITE 1000
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5025
Practice Address - Country:US
Practice Address - Phone:303-649-9500
Practice Address - Fax:303-706-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COESP1045152W00000X
COOPT.0001045152W00000X
COOPT.0002548152W00000X
COOPT.0002131152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y07415Medicare UPIN
COY07415Medicare UPIN
C532448Medicare PIN