Individual provider Active NPI

Jason M Klepfisz, O.D.

  • Optometrist
  • Phoenix, AZ
National Provider Identifier
1083046288
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2986 Issued in CO
Practice address
3201 W Peoria Ave
Suite D704
Phoenix, AZ 85029-4608
Phone
(602) 944-7642
NPI assigned
Jul 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2986 CO Primary

Addresses

Primary practice location

3201 W Peoria Ave
Suite D704
Phoenix, AZ 85029-4608

Mailing address

3201 W Peoria Ave
Suite D704
Phoenix, AZ 85029-4608
Phone (602) 944-7642

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150120000669 AZ Practitioner - Optometry 9537483698 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2986COMDDental Hygienist
2010AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Eye Care PC Optometrist CurrentSince Nov 11, 2014 Accepting new patients

Locations

1940 S Country Club Dr
Ste 102
Mesa, AZ 85210
Phone (480) 834-6367

3201 W Peoria Ave
Ste D704
Phoenix, AZ 85029
Phone (602) 843-4844

300 W Clarendon Ave
Ste 150
Phoenix, AZ 85013
Phone (602) 265-0343

Organizations & group practices 1

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": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1083046288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 W PEORIA AVE",
            "address_2": "SUITE D704",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294608",
            "telephone_number": "602-944-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W PEORIA AVE",
            "address_2": "SUITE D704",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294608",
            "telephone_number": "602-944-7642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEPFISZ",
        "first_name": "JASON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.