BROOKE LALLY OD
NPI 1063264034
Optometrist in Pueblo, CO
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
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Brooke Lally reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Pueblo, CO 81008
- Reassigned Medicare billing, Colorado enrollment
- 7 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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.
PUEBLO, CO 81008
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.
Which organization bills Medicare for Brooke Lally's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Brooke Lally reassigns Medicare benefits to Family Eye Center Incorporated (Pueblo, CO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Brooke Lally's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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, Providence Health Plan and Select Health 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 14 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.
# Brooke Lally, OD · NPI 1063264034
Optometrist provider in Pueblo, Colorado. Individual provider, active in the CMS NPPES registry since April 3, 2024.
## Identity
- **NPI:** 1063264034 (Entity type: Individual)
- **Enumerated:** April 3, 2024
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** 0004130 (Colorado)
- **Sole proprietor:** No
## Practice location
- **Address:** 712 FORTINO BLVD, Pueblo, CO 81008-2084
- **Phone:** (719) 542-0236
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Family Eye Center Incorporated (NPI 1912116195, Pueblo, CO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** August 4, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1063264034) · Data from the CMS NPPES public registry.