Organization Active NPI

Dr. Kelly a. Cross & Associates, P.C.

  • Optometrist
  • Phoenix, AZ
National Provider Identifier
1063611366
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
910 Issued in AZ
Legal business name
DR. KELLY A. CROSS & ASSOCIATES, P.C.
Practice address
19001 N 27TH Ave
Phoenix, AZ 85027-5036
Phone
(623) 293-4412
NPI assigned
Jul 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Authorized official

Name
Dr. Kelly Cross Pyritz, O.D.NPI 1851436661
Title
Owner
Phone
(480) 816-8810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 910 AZ Primary

Addresses

Primary practice location

19001 N 27TH Ave
Phoenix, AZ 85027-5036

Mailing address

19001 N 27TH Ave
Phoenix, AZ 85027-5036
Phone (623) 293-4412

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031218000832 AZ Part B Supplier - Clinic/Group Practice 4587561295 Receives reassigned benefits from 5 practitioners
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

19001 N 27th Ave
Phoenix, AZ 85027
Phone (623) 293-4402

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1063611366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19001 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850275036",
            "telephone_number": "623-293-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19001 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850275036",
            "telephone_number": "623-293-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KELLY A. CROSS & ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "PYRITZ",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "CROSS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-816-8810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.