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BROOKE LALLY OD
NPI 1063264034
Optometrist in Pueblo, CO

Active since April 03, 2024PECOS EnrolledAccepts Medicare Assignment
712 FORTINO BLVD, PUEBLO, CO 81008(719) 542-0236 Get Directions Write a Review

NPPES record last updated: August 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 4, 2025, Jun 27, 2025, Apr 3, 2024 (3 updates tracked since 2024).

About Brooke Lally Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROOKE LALLY OD (NPI 1063264034) is an individual optometrist in Pueblo, Colorado, licensed in Colorado (0004130) and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Pueblo West, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1063264034
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameBROOKE LALLYCredential: OD
Location Address712 FORTINO BLVDPueblo, CO 81008-2084
Mailing Address712 Fortino BlvdPueblo, CO 81008-2084
Phone(719) 542-0236
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateApril 3, 2024
Last NPPES UpdateAugust 4, 20253 updates tracked since enumeration
NPPES CertifiedAugust 4, 2025
✔ NPI 1063264034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in CO · 0004130✔ Licensed in MO · 2025023993
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
712 FORTINO BLVD, Pueblo, CO 81008
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Secondary Practice Location 1

Location 1332 S Orchard Springs Dr Ste 120Pueblo West, CO 81007-6154 · Phone (719) 547-7709

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brooke Lally Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173022282
PECOS Enrollment IDI20250815003185
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 81008 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$132.55 typical visit price
range $58.06 – $174.82
Typical copayment $33.13 (range $14.51 – $43.70)
Most-billed visit code 99204
Established Patient
$72.20 typical visit price
range $18.88 – $142.79
Typical copayment $18.05 (range $4.72 – $35.69)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STEVEN RAY CLOUGH O.D.
Optometrist
712 FORTINO BLVD
PUEBLO, CO 81008
Pueblo County (719) 542-0236
PUEBLO AUDIOLOGY CENTER
Audiologist
712 FORTINO BLVD, SUITE D
PUEBLO, CO 81008
Pueblo County (719) 542-1760
MRS. KAREN MALOTT GACNIK M.S. CCC-A
Audiologist (Assistive Technology Practitioner)
712 FORTINO BLVD, STE. D
PUEBLO, CO 81008
Pueblo County (719) 542-1760
FAMILY EYE CENTER INCORPORATED
Optometrist
712 FORTINO BLVD
PUEBLO, CO 81008
Pueblo County (719) 542-0236

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brooke Lally's NPI number?

The NPI number for Brooke Lally is 1063264034. It was assigned to this individual provider in the NPPES registry on April 3, 2024.

Where is Brooke Lally located?

Brooke Lally practices at 712 Fortino Blvd, Pueblo, CO 81008. The listed phone number is (719) 542-0236.

What is Brooke Lally's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Brooke Lally enrolled in Medicare?

Yes. Brooke Lally is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Brooke Lally accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Providence Health Plan list Brooke Lally as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Brooke Lally was last updated on August 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.