NPIMap

Organization Active NPI

Southwestern Eye Center LTD

  • Durable Medical Equipment & Medical Supplies
  • Mesa, AZ
National Provider Identifier
1063980662
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SOUTHWESTERN EYE CENTER LTD
Practice address
1121 S Gilbert Rd Ste 103
Mesa, AZ 85204-5235
Phone
(480) 854-3310
Fax
(480) 854-1157
NPI assigned
Nov 13, 2018
Last updated
Jan 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Authorized official

Name
Dr. Arthur D Brookfield
Title
Chief Financial Officer
Phone
(602) 598-7488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1121 S Gilbert Rd Ste 103
Mesa, AZ 85204-5235

Mailing address

63 S Rockford Dr Ste 220
Tempe, AZ 85288-6226
Phone (602) 598-7488

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190321000530 AZ DME Supplier - Physician - Optometrist 1850296989 Practice locations: Mesa, AZ

Other NPIs with the same Medicare PAC ID 23

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

View all 23

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2163757Southwestern Eye Center - Mesa Gilbert Rd1121 S Gilbert Rd, Suite 103, Mesa, AZ 85204Certificate of waiverMar 19, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Southwestern Eye Center1121 S Gilbert Rd, Mesa, AZ 85204-5235(480) 854-3310 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Dec 19, 2011

National Provider Directory

National Provider Directory
Tax ID family
Lance Wozniak MD18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1063980662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 S ROCKFORD DR STE 220",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852886226",
            "telephone_number": "602-598-7488",
            "fax_number": "602-231-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 S GILBERT RD STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045235",
            "telephone_number": "480-854-3310",
            "fax_number": "480-854-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN EYE CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "BROOKFIELD",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "602-598-7488",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.