Organization Active NPI

Eye Physicians & Surgeons of Arizona, PC

  • Ophthalmology Physician
  • Glendale, AZ
National Provider Identifier
1124140504
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
16811 Issued in AZ
Legal business name
EYE PHYSICIANS & SURGEONS OF ARIZONA, PC
Practice address
6677 W Thunderbird Rd
Suite F 101
Glendale, AZ 85306-3709
Phone
(623) 878-3939
Fax
(623) 878-5567
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Authorized official

Name
George Ronald Reiss, MDNPI 1619927969
Title
President
Phone
(623) 878-3939

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 16811 AZ Primary

Addresses

Primary practice location

6677 W Thunderbird Rd
Suite F 101
Glendale, AZ 85306-3709

Mailing address

6677 W Thunderbird Rd
Suite F 101
Glendale, AZ 85306-3709
Phone (623) 878-3939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080214000487 AZ Part B Supplier - Clinic/Group Practice 0244313179 Receives reassigned benefits from 14 practitioners
Practice locations: Buckeye, AZ; Tuba City, AZ; Scottsdale, AZ; Sacaton, AZ; Goodyear, AZ; Glendale, AZ; Chandler, AZ; Avondale, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2288507Eye Physicians and Surgeons of Arizona6677 W Thunderbird BLDG F Ste 101 a, Glendale, AZ 85306Certificate of waiverAug 24, 2027

National Provider Directory

National Provider Directory

Locations

6677 W Thunderbird Rd
Ste F101
Glendale, AZ 85306

6677 W Thunderbird Rd
Ste 101
Glendale, AZ 85306

10603 N Hayden Rd
Ste H100
Scottsdale, AZ 85260

10619 N Hayden Rd
Ste 101A
Scottsdale, AZ 85260
Phone (480) 798-0733

10603 N Hayden Rd
Bldg H
Scottsdale, AZ 85260
Phone (480) 664-4977

10603 N Hayden Rd
#100
Scottsdale, AZ 85260

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1615/brand/1/csg/1/fhir/r4
  • Direct secure messaging: greiss@eyesarizona.intellechartdirect.net
  • Direct secure messaging: sgross@eyesarizona.intellechartdirect.net
  • Direct secure messaging: bhoyt@eyesarizona.intellechartdirect.net
  • Direct secure messaging: spatel@eyesarizona.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452729600000",
    "number": "1124140504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6677 W THUNDERBIRD RD",
            "address_2": "SUITE F 101",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063709",
            "telephone_number": "623-878-3939",
            "fax_number": "623-878-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6677 W THUNDERBIRD RD",
            "address_2": "SUITE F 101",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063709",
            "telephone_number": "623-878-3939",
            "fax_number": "623-878-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE PHYSICIANS & SURGEONS OF ARIZONA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2016-01-14",
        "status": "A",
        "authorized_official_last_name": "REISS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-878-3939",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "16811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.