Active NPI
Nationwide Vision Center, LLC
- Optician
- Tucson, AZ
National Provider Identifier
1073683041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- Legal business name
- NATIONWIDE VISION CENTER, LLC
- Practice address
- 3880 W Ina Rd
Suite 132
Tucson, AZ 85741-2355 - Phone
- (520) 579-9641
- Fax
- (520) 579-9644
- NPI assigned
- Nov 8, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joseph Pravoot Gira, MD
- Title
- Chief Medical Officer
- Phone
- (314) 909-0633
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | Primary |
Addresses
Primary practice location
3880 W Ina Rd
Suite 132
Tucson, AZ 85741-2355
Mailing address
955 W Southern Ave Ste 101
Mesa, AZ 85210-4903
Phone (480) 961-1865
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131217000251 | AZ | Part B Supplier - Clinic/Group Practice | 6901033075 |
Receives reassigned benefits from 131 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
3880 W Ina Rd
Ste 132
Tucson, AZ 85741
Phone (520) 579-9641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1671062400000",
"number": "1073683041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "955 W SOUTHERN AVE STE 101",
"city": "MESA",
"state": "AZ",
"postal_code": "852104903",
"telephone_number": "480-961-1865",
"fax_number": "480-893-8172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3880 W INA RD",
"address_2": "SUITE 132",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857412355",
"telephone_number": "520-579-9641",
"fax_number": "520-579-9644"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NATIONWIDE VISION CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-08",
"last_updated": "2022-12-15",
"certification_date": "2022-12-15",
"status": "A",
"authorized_official_last_name": "GIRA",
"authorized_official_first_name": "JOSEPH",
"authorized_official_middle_name": "PRAVOOT",
"authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
"authorized_official_telephone_number": "314-909-0633",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.