NPIMap

Organization Active NPI

Swagel-Wootton Eye Center, Inc

  • Clinic/Center
  • Mesa, AZ
National Provider Identifier
1063484459
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SWAGEL-WOOTTON EYE CENTER, INC
Doing business as
Swagel-Wootton Eye Institute
Practice address
220 S 63Rd St
Mesa, AZ 85206-1619
Phone
(480) 641-3937
Fax
(480) 924-5072
NPI assigned
Feb 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Authorized official

Name
Christian Ellison
Title
Ceo
Phone
(720) 273-7449

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X AZ Primary

Addresses

Primary practice location

220 S 63Rd St
Mesa, AZ 85206-1619

Mailing address

PO Box 200414
Dallas, TX 75320-3941
Phone (205) 241-0017

Other practice location 1

3940 S Alma School Rd Ste 3
Chandler, AZ 85248-4513
Phone (480) 786-6086

Other names 1

  • Swagel-Wootton Eye Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040521000065 AZ Part B Supplier - Clinic/Group Practice 9335130046 Receives reassigned benefits from 14 practitioners
Practice locations: Chandler, AZ; Mesa, AZ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Eye Surgery Center of Arizona2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3940 S Alma School Rd
Ste 3
Chandler, AZ 85248
Phone (480) 641-3937

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1063484459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200414",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753203941",
            "telephone_number": "205-241-0017",
            "fax_number": "720-524-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S 63RD ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061619",
            "telephone_number": "480-641-3937",
            "fax_number": "480-924-5072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3940 S Alma School Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852484513",
            "country_code": "US",
            "telephone_number": "480-786-6086",
            "fax_number": "480-786-3956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SWAGEL-WOOTTON EYE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "720-273-7449"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Swagel-Wootton Eye Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.