Individual provider Active NPI

Tami Cordt Friske, OD

  • Optometrist
  • Tucson, AZ
National Provider Identifier
1003812256
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
520 Issued in AZ
Practice address
5720 E Broadway Blvd
Tucson, AZ 85711-3814
Phone
(520) 747-8583
Fax
(520) 747-8561
NPI assigned
Jun 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 520 AZ Primary
Corneal and Contact Management Optometrist 152WC0802X 520 AZ
Pediatric Optometrist 152WP0200X 520 AZ
Vision Therapy Optometrist 152WV0400X 520 AZ

Addresses

Primary practice location

5720 E Broadway Blvd
Tucson, AZ 85711-3814

Mailing address

4464 N Little Rock Dr
Tucson, AZ 85750-6900
Phone (520) 749-4973

Other identifiers 5

IdentifierTypeStateIssuer
WCKGLMedicaidAZ
2477048OtherAZAETNA
2Z4440OtherAZHEALTHNET
AZ0175250OtherAZBCBS
S5055OtherAZDME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110405000316 AZ Practitioner - Optometry 1456460641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1200 N El Dorado PL
Suite G 750
Tucson, AZ 85715-4637
Phone (520) 747-8583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
520AZMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tami C. Friske, O.D., PC Optometrist CurrentSince Oct 1, 1991 Accepting new patients

Locations

5720 E Broadway Blvd
Tucson, AZ 85711
Phone (520) 747-8583

1200 N El Dorado Pl
Ste G750
Tucson, AZ 85715
Phone (520) 747-8583

Networks

  • NM HMO C-SNP

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1003812256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4464 N LITTLE ROCK DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857506900",
            "telephone_number": "520-749-4973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 E BROADWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113814",
            "telephone_number": "520-747-8583",
            "fax_number": "520-747-8561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRISKE",
        "first_name": "TAMI",
        "middle_name": "CORDT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "520",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "AZ",
            "license": "520",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "AZ",
            "license": "520",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "AZ",
            "license": "520",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WCKGL",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2477048",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2Z4440",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0175250",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "S5055",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.