CMS-1500 Box 24J / 33a • NPI
1669442661
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
152W00000X (CMS 41)
Licensed & Credentialed Eye and Vision Service Providers — Optometrist
Box 32 Service Location & ZIP+4
216 S MAIN ST, STE 2, BRECKENRIDGE, CO, 80424
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1669442661 (DUSTIN CLARK ANDERSON, O.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
No
Hospice Referring
✓ Eligible
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1669442661 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | DUSTIN CLARK ANDERSON, O.D. |
| Plain-English Specialty | Licensed & Credentialed Eye and Vision Service Providers — Optometrist NUCC Code: 152W00000X (Optometrist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 216 S MAIN ST, STE 2, BRECKENRIDGE, CO, 80424 |
| Practice Telephone / Fax | Tel: (970) 453-2020 | Fax: (970) 547-5865 |
| Administrative Mailing Address | PO BOX 4654, BRECKENRIDGE, CO, 80424-4654 |
| Enumeration & Last Sync | Enumerated: 2006-01-24 | CMS Record Updated: 2025-11-12 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (152W00000X)
What Does Taxonomy Code 152W00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 152W00000X translates to:
"Licensed & Credentialed Eye and Vision Service Providers — Optometrist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (DUSTIN CLARK ANDERSON, O.D.)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
152W00000X — OptometristPlain English: Licensed & Credentialed Eye and Vision Service Providers — Optometrist | State: TX | License: 05890 | Primary: Secondary |
152W00000X — OptometristPlain English: Licensed & Credentialed Eye and Vision Service Providers — Optometrist | State: CO | License: 2952 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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