Tina Cooley Staley, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

882 Issued in AZ

Practice address

1780 E Boston St
Ste 101
Gilbert, AZ 85295-6244

Phone

(480) 813-7050

Fax

(480) 813-3630

NPI assigned

Feb 21, 2007

Last updated

Aug 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Southern College of Optometry, 1993

Medicare assignment

May accept Medicare assignment

Group practices

Eye Care Clinic P.C.Group PAC ID 6608868229, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eye Care Clinic P.C.

  dba Val Vista Vision Center

  • Optometrist
  • Gilbert, AZ
  • NPI 1659515484
  Medicare reassignment Care Compare group NPD Authorized official
• MVP.Vision

  • Optometrist
  • Gilbert, AZ
  • NPI 1902445604
  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1114062668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 E BOSTON ST STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956246",
            "telephone_number": "480-813-7050",
            "fax_number": "480-813-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 E BOSTON ST",
            "address_2": "STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956244",
            "telephone_number": "480-813-7050",
            "fax_number": "480-813-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOLEY STALEY",
        "first_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brodie Cook, DMD
• Kimberly Cook, M.S., PA-C
• Lauren Cook
• Nathan Cook, PAC
• Sarah Lynn Cook
• Cooley Station Kids Dentist and Orthodontics, LLP (Cooley Station Dental Group)
• Abigail Renee Cooley
• Aaron A. Coon, P.A.
• Christian Coon
• Gloria Coon

• Optometrist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.