Individual provider Active NPI

Joshua John Roden, OD

  • Optometrist
  • Avondale, AZ
National Provider Identifier
1104486653
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-002348 Issued in AZ
Practice address
10000 W McDowell Rd
Avondale, AZ 85392-4803
Phone
(602) 882-8711
NPI assigned
Jun 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-002348 AZ Primary

Addresses

Primary practice location

10000 W McDowell Rd
Avondale, AZ 85392-4803

Mailing address

737 E Myrtle Ave
Phoenix, AZ 85020-5034

Other practice location 1

7245 E Osborn Rd Ste 4
Scottsdale, AZ 85251-6443
Phone (480) 994-5012

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
I20200424001295 AZ Practitioner - Optometry 8628408135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Ophthalmologists LTDGroup PAC ID 8325024805, 17 clinicians

Practice addresses (Care Compare)

7245 E Osborn Rd
Suite 4
Scottsdale, AZ 85251-6443
Phone (602) 991-5012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-002348AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Ophthalmologists LTD CurrentSince Apr 1, 2020 Accepting new patients
Brian T. Rose, MD, PLC PastSince Sep 1, 2004 Accepting new patients
Associated Ophthalmologist, LTD Optometrist Past Accepting new patients

Locations

4915 E Baseline Rd
Ste 114
Gilbert, AZ 85234
Phone (480) 830-0012

300 E Osborn Rd
Ste 100
Phoenix, AZ 85012
Phone (602) 200-0770

7373 N Scottsdale Rd
Ste D100
Scottsdale, AZ 85253

7245 E Osborn Rd
Ste 4
Scottsdale, AZ 85251
Phone (480) 994-5012

7571 S Willow Dr
Tempe, AZ 85283

7571 S Willow Dr
Ste 101
Tempe, AZ 85283
Phone (480) 822-6230

Organizations & group practices 3

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": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1104486653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 E MYRTLE AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W MCDOWELL RD",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853924803",
            "telephone_number": "602-882-8711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7245 E Osborn Rd Ste 4",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852516443",
            "country_code": "US",
            "telephone_number": "480-994-5012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODEN",
        "first_name": "JOSHUA",
        "middle_name": "JOHN",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.