MEDICARE: BLUEBELL VISION PLLC

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

General Provider Information

NPI Number	:	1881489656
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUEBELL VISION PLLC

Provider Business Mailing Address
First Line	:	PO BOX 63780
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80962-3780
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4385 VENETUCCI BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4049
Country	:	US
Telephone Number	:	719-380-0750
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHELSEY NOLASCO
Credential	:	OD
Telephone Number	:	719-597-2311

Provider Enumeration Date	:	04/11/2025
Last Update Date	:	09/09/2025

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