Individual provider Active NPI

Craig R Cassidy, DO

  • Ophthalmology Physician
  • Mesa, AZ
National Provider Identifier
1063480119
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
1769 Issued in AZ
Practice address
160 W University
Suite 1
Mesa, AZ 85201
Phone
(480) 833-0014
Fax
(480) 835-6821
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 1769 AZ Primary

Addresses

Primary practice location

160 W University
Suite 1
Mesa, AZ 85201

Mailing address

160 W University
Suite 1
Mesa, AZ 85201
Phone (480) 833-0014

Other identifiers 1

IdentifierTypeStateIssuer
237314MedicaidAZ

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031110000681 AZ Practitioner - Ophthalmology 8325951957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.86 of 100Reported as group
Quality
81.82
Promoting interoperability
100
Improvement activities
40
Cost
64.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Barnet Dulaney Perkins Eye Center, PC Ophthalmology CurrentSince Oct 18, 2021 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC CurrentSince Oct 18, 2021 Accepting new patients

Locations

5620 W Thunderbird Rd
Ste C5
Glendale, AZ 85306
Phone (602) 274-4992

160 W University Dr
Ste 1
Mesa, AZ 85201
Phone (480) 833-0014

4800 N 22nd St
Ste 120
Phoenix, AZ 85016

2125 W Indian School Rd
Phoenix, AZ 85015
Phone (602) 274-4992

9849 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 583-2020

Interoperability endpoints

  • Direct secure messaging: craig.cassidy.p11@direct.avp.nextgenshare.com

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1063480119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 W UNIVERSITY",
            "address_2": "SUITE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85201",
            "telephone_number": "480-833-0014",
            "fax_number": "480-835-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 W UNIVERSITY",
            "address_2": "SUITE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85201",
            "telephone_number": "480-833-0014",
            "fax_number": "480-835-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "CRAIG",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "1769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "237314",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.