MEDICARE: RIDGELINE EYECARE ASSOCIATES

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
2	207W00000X	Ophthalmology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659824217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIDGELINE EYECARE ASSOCIATES

Provider Business Mailing Address
First Line	:	755 S PERRY ST STE 100
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-1923
Country	:	US
Telephone Number	:	720-531-0688
Fax Number	:

Provider Business Practice Location Address
First Line	:	755 S PERRY ST STE 100
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-1923
Country	:	US
Telephone Number	:	720-531-0688
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEFFREY JONES
Credential	:	MD
Telephone Number	:	720-531-0688

Provider Enumeration Date	:	08/01/2016
Last Update Date	:	01/05/2026

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