Dr. Ryan Ambrose, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DR. RYAN AMBROSE, PLLC

Practice address

3870 W Happy Valley Rd Ste 150
Glendale, AZ 85310-3296

Phone

(623) 362-8642

Fax

(623) 561-1190

NPI assigned

Jun 27, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Ryan David Ambrose, ODNPI 1558711507

Title

Owner/Optometrist

Phone

(262) 295-5154

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan David Ambrose, OD

  • Optometrist
  • Avondale, AZ
  • NPI 1558711507
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1033954599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6761 E KELTON LN",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852545645",
            "telephone_number": "262-295-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3870 W HAPPY VALLEY RD STE 150",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853103296",
            "telephone_number": "623-362-8642",
            "fax_number": "623-561-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RYAN AMBROSE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "AMBROSE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "262-295-5154",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1558711507",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dr Harshad Patel MD PC
• Dr. Farzin Allameh DDS PC
• Dr. Greg Ceyhan DDS, PLLC
• Dr. John Schrolucke, Optometrist
• Dr. Mark L. Jaffe
• Patricia Ann Drace, M.D.
• Mason Drajer
• Rebecca Drake
• Remi Cyril Drake
• Vicky Dramaretska, PA-C

• Optometrist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.