Individual provider Active NPI

Erik Nathanael Burnett, OD

  • Corneal and Contact Management Optometrist
  • Tucson, AZ
National Provider Identifier
1093015596
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
1998 Issued in AZ
Practice address
4730 E Pima St
Tucson, AZ 85712-3521
Phone
(520) 795-3956
Fax
(520) 318-3431
NPI assigned
Oct 30, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 1998 AZ Primary

Addresses

Primary practice location

4730 E Pima St
Tucson, AZ 85712-3521

Mailing address

4730 E Pima St
Tucson, AZ 85712-3521
Phone (520) 795-3956

Other practice location 1

2623 Yorba Linda Blvd Apt 323
Fullerton, CA 92831-1653
Phone (520) 260-5223

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
I20170516001362 AZ Practitioner - Optometry 3779860069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edmonds, Husz and Pemberton Eye CenterGroup PAC ID 5991785768, 4 clinicians

Practice addresses (Care Compare)

4730 E Pima St
Tucson, AZ 85712-3521
Phone (520) 795-3956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Edmonds, Husz & Pemberton Eye Center Optometrist CurrentSince Apr 20, 2017 Accepting new patients

Locations

4730 E Pima St
Tucson, AZ 85712
Phone (520) 795-3956

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": "1288396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1093015596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 E PIMA ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857123521",
            "telephone_number": "520-795-3956",
            "fax_number": "520-318-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 E PIMA ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857123521",
            "telephone_number": "520-795-3956",
            "fax_number": "520-318-3431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2623 Yorba Linda Blvd Apt 323",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928311653",
            "country_code": "US",
            "telephone_number": "520-260-5223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "ERIK",
        "middle_name": "NATHANAEL",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-30",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "AZ",
            "license": "1998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.