Individual provider Active NPI

Alma D. Yamamoto, O.D.

  • Optometrist
  • Gilbert, AZ
National Provider Identifier
1053624650
Registry record updated Oct 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1759 Issued in AZ
Practice address
67 S Higley Rd Ste 104
Gilbert, AZ 85296-1167
Phone
(480) 219-5175
Fax
(480) 935-0623
NPI assigned
Jul 23, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1759 AZ Primary

Addresses

Primary practice location

67 S Higley Rd Ste 104
Gilbert, AZ 85296-1167

Mailing address

67 S Higley Rd Ste 104
Gilbert, AZ 85296-1167
Phone (480) 219-5175

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
I20110222000976 AZ Practitioner - Optometry 0648451708 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

67 S Higley Rd
Suite 104
Gilbert, AZ 85296-1167
Phone (480) 219-5175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1759AZMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Tree Eye Care LLC Optometrist CurrentSince Nov 20, 2018 Accepting new patients

Locations

67 S Higley Rd
Ste 104
Gilbert, AZ 85296
Phone (480) 219-5175

Organizations & group practices 3

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": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603497600000",
    "number": "1053624650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 S HIGLEY RD STE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961167",
            "telephone_number": "480-219-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 S HIGLEY RD STE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961167",
            "telephone_number": "480-219-5175",
            "fax_number": "480-935-0623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAMOTO",
        "first_name": "ALMA",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-23",
        "last_updated": "2020-10-24",
        "certification_date": "2020-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.