Individual provider Active NPI

Jill Rago

  • Optometrist
  • Scottsdale, AZ
National Provider Identifier
1003986183
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
973 Issued in AZ
Practice address
20301 N Hayden Rd Ste 100
Scottsdale, AZ 85255-3881
Phone
(480) 991-0509
Fax
(480) 419-9515
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 973 AZ Primary

Addresses

Primary practice location

20301 N Hayden Rd Ste 100
Scottsdale, AZ 85255-3881

Mailing address

27933 N 114TH Way
Scottsdale, AZ 85262-5693

Other names 1

  • Jill Ingram Former name

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
I20071018000809 AZ Practitioner - Optometry 1153417332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optics of Scottsdale LLCGroup PAC ID 2961582408, 2 clinicians

Practice addresses (Care Compare)

20301 N Hayden Rd
Suite 100
Scottsdale, AZ 85255-3881
Phone (480) 991-0509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
973AZMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optics of Scottsdale LLC Optometrist CurrentSince Dec 11, 2007 Accepting new patients
Riviera Opticare Inc. Optometrist Past Accepting new patients

Locations

20301 N Hayden Rd
Ste 100
Scottsdale, AZ 85255
Phone (480) 991-0509

Organizations & group practices 2

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1003986183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27933 N 114TH WAY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852625693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20301 N HAYDEN RD STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852553881",
            "telephone_number": "480-991-0509",
            "fax_number": "480-419-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGO",
        "first_name": "JILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "INGRAM",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.