Organization Active NPI

Jason Merrell OD PLLC

  • Optometrist
  • Mesa, AZ
National Provider Identifier
1124783378
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JASON MERRELL OD PLLC
Practice address
1606 S Signal Butte Rd
Mesa, AZ 85209-1482
Phone
(480) 358-9737
Fax
(480) 358-9739
NPI assigned
Nov 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Authorized official

Name
Jason Merrell, ODNPI 1861922601
Title
Owner
Phone
(208) 390-0826

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1606 S Signal Butte Rd
Mesa, AZ 85209-1482

Mailing address

1661 E Luna Blanca Way
San Tan Valley, AZ 85140-8466
Phone (208) 390-0826

Other practice location 1

8340 W McDowell Rd
Phoenix, AZ 85037-4101
Phone (623) 936-0613

Other practice location 2

1695 N Arizona Blvd
Coolidge, AZ 85128-9128
Phone (520) 723-8641

Other practice location 3

1710 S Greenfield Rd
Mesa, AZ 85206-3481
Phone (480) 892-6954

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260522001105 AZ Part B Supplier - Clinic/Group Practice 9436629128 Receives reassigned benefits from 1 practitioner
Practice locations: San Tan Valley, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1124783378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 E LUNA BLANCA WAY",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851408466",
            "telephone_number": "208-390-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 S SIGNAL BUTTE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852091482",
            "telephone_number": "480-358-9737",
            "fax_number": "480-358-9739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8340 W McDowell Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850374101",
            "country_code": "US",
            "telephone_number": "623-936-0613",
            "fax_number": "623-936-0653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1695 N Arizona Blvd",
            "address_purpose": "LOCATION",
            "city": "Coolidge",
            "state": "AZ",
            "postal_code": "851289128",
            "country_code": "US",
            "telephone_number": "520-723-8641",
            "fax_number": "520-723-8643",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1710 S Greenfield Rd",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852063481",
            "country_code": "US",
            "telephone_number": "480-892-6954",
            "fax_number": "480-892-6956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JASON MERRELL OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-02",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "MERRELL",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-390-0826",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; 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.