Madison Street Provider Network Inc is a
Ophthalmology based in Fort Collins, Colorado. Madison Street Provider Network Inc is licensed to practice in * (Not Available) (license number ) and their current practice location is
4103 Boardwalk Dr Unit 100, Fort Collins, Colorado. It can be reached at their office (for appointments etc.) via phone at
(303) 393-8565.
NPI number for Madison Street Provider Network Inc is 1154928331 and their current mailing address is Po Box 912914, Denver, Colorado. Madison Street Provider Network Inc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1154928331.
Healthcare Provider's Profile
| Full Name | Madison Street Provider Network Inc |
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| Type | Facility |
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| Speciality | Ophthalmology |
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| Location | 4103 Boardwalk Dr Unit 100, Fort Collins, Colorado |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1154928331
- Provider Enumeration Date: 10/01/2020
- Last Update Date: 10/01/2020
Medical Identifiers
Medical identifiers for Madison Street Provider Network Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154928331 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Madison Street Provider Network Inc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Madison Street Provider Network Inc
Po Box 912914,
Denver, CO 80291-2914
Ph: () - | Madison Street Provider Network Inc
4103 Boardwalk Dr Unit 100,
Fort Collins, CO 80525-5933
Ph: (303) 393-8565 |
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