East Valley Glaucoma Inc

Primary specialty

Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X

License

15705 Issued in AZ

Legal business name

EAST VALLEY GLAUCOMA INC

Practice address

6402 E Superstition Springs Blvd Ste 104
Mesa, AZ 85206-4391

Phone

(480) 981-3317

Fax

(480) 981-5308

NPI assigned

Feb 10, 2017

Organization subpart

No

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

Authorized official

Name

Robert C Spurny, M.D.NPI 1942232798

Title

Owner

Phone

(480) 981-3317

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert C Spurny Sr., MD

  • Glaucoma Specialist (Ophthalmology) Physician
  • Mesa, AZ
  • NPI 1942232798
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614124800000",
    "number": "1114465010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6402 E SUPERSTITION SPRINGS BLVD STE 209",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064393",
            "telephone_number": "480-981-3317",
            "fax_number": "480-981-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6402 E SUPERSTITION SPRINGS BLVD STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064391",
            "telephone_number": "480-981-3317",
            "fax_number": "480-981-5308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1440 S Country Club Dr",
            "address_2": "SUITE 24",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852109701",
            "country_code": "US",
            "telephone_number": "480-981-3317",
            "fax_number": "480-981-5308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EAST VALLEY GLAUCOMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-10",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A",
        "authorized_official_last_name": "SPURNY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-981-3317",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "15705",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "AZ",
            "license": "15705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "Z202876",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Valley Diagnostic Imaging LLC
• East Valley Diagnostics LLC
• East Valley Direct Primary Care LLC
• East Valley Endoscopy LLC
• East Valley Footcare PLLC
• East Valley Hearing Center Inc
• East Valley Hospice P.L.C.
• East Valley Implant & Periodontal Center
• East Valley Implant and Periodontal PLLC
• East Valley Infectious Disease Medicine LLC

• Glaucoma Specialist (Ophthalmology) Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Glaucoma Specialist (Ophthalmology) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.

Verify at the official NPI Registry.