Bryan Blare, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

712 Issued in AZ

Practice address

955 W Southern Ave Ste 122
Mesa, AZ 85210-4903

Phone

(480) 835-4440

Fax

(480) 835-8882

NPI assigned

Sep 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, NM2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

93.48 of 100Reported as group

Quality

100

Improvement activities

40

Cost

78.27

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kblare@direct.eyecare-partners.com

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.

• Emilio Martin Justo MD PC

  • Ophthalmology Physician
  • Sun City, AZ
  • NPI 1801902762
  Medicare reassignment NPD
• Family First Vision Care Arizona PLLC

  • Optometrist
  • Phoenix, AZ
  • NPI 1639875826
  Medicare reassignment NPD
• Visionworks, Inc.

  • Optometrist
  • Albuquerque, NM
  • NPI 1801960620
  Medicare reassignment NPD
• Family First Vision Care Arizona PLLC

  • Optometrist
  • Phoenix, AZ
  • NPI 1710417514
  NPD
• Visionworks, Inc

  • Eyewear Supplier
  • Simpsonville, SC
  • NPI 1699571166
  NPD
• Nationwide Optometry P.C.

  • Optometrist
  • Phoenix, AZ
  • NPI 1073683348
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1063409548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-3246",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911100001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W SOUTHERN AVE STE 122",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104903",
            "telephone_number": "480-835-4440",
            "fax_number": "480-835-8882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 E Guadalupe Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852345116",
            "country_code": "US",
            "telephone_number": "480-558-0600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 E Camelback Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850163427",
            "country_code": "US",
            "telephone_number": "602-840-3501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLARE",
        "first_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eddie Lee Blakes Jr., DBH, LIAC
• Melissa Blanchard, M.ED.
• Timothy Blanckaert
• Daylene Lynn Blankenship
• Zachary Blankenship
• Kachina Blaser
• Garrett John Blatter, DO
• Brittney Blau
• Duane K Blau
• Russell Webb Blau, PT, DPT, MBA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.