MEDICARE: DR. JASON TROY ORTMAN OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2238	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	803357	OTHER	CO	GROUP MIDWEST EYE ASSOC

General Provider Information

NPI Number	:	1578545828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON TROY ORTMAN OD

Provider Business Mailing Address
First Line	:	250 MAX DR
Second Line	:	101
City	:	CASTLE PINES
State	:	CO
Zip	:	80108-9517
Country	:	US
Telephone Number	:	303-688-5066
Fax Number	:	303-688-6986

Provider Business Practice Location Address
First Line	:	250 MAX DR
Second Line	:	101
City	:	CASTLE PINES
State	:	CO
Zip	:	80108-9517
Country	:	US
Telephone Number	:	303-688-5066
Fax Number	:	303-688-6986

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	03/22/2016

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