Individual provider Active NPI

Jonathan Jay Levin, MD

  • Ophthalmology Physician
  • Phoenix, AZ
National Provider Identifier
1144409137
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
51173 Issued in MN
Practice address
18325 N Allied Way
Suite 100
Phoenix, AZ 85054-3105
Phone
(602) 467-4966
Fax
(480) 419-5401
NPI assigned
Oct 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 51173 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

18325 N Allied Way
Suite 100
Phoenix, AZ 85054-3105

Mailing address

18325 N Allied Way
Suite 100
Phoenix, AZ 85054-3105
Phone (602) 467-4966

Other identifiers 2

IdentifierTypeStateIssuer
ENROLLEDMedicaidMN
ENROLLEDMedicaidIA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110804000721 AZ Practitioner - Ophthalmology 5991872186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Medical College of Wisconsin, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Vision IncGroup PAC ID 1658350236, 17 clinicians

Practice addresses (Care Compare)

18325 N Allied Way
Suite 100
Phoenix, AZ 85054-3106
Phone (602) 953-3339

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1247

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51173MNMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Vision Inc Ophthalmology CurrentSince Aug 11, 2011 Accepting new patients

Locations

740 N Estrella Pkwy
Ste 110
Goodyear, AZ 85338

16150 N Arrowhead Fountains Ctr Dr
Ste 150
Peoria, AZ 85382
Phone (480) 949-5990

18325 N Allied Way
Ste 100
Phoenix, AZ 85054
Phone (602) 467-4966

20940 N Tatum Blvd
Ste 370
Phoenix, AZ 85050
Phone (480) 563-8787

Organizations & group practices 1

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": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1144409137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18325 N ALLIED WAY",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850543105",
            "telephone_number": "602-467-4966",
            "fax_number": "480-419-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18325 N ALLIED WAY",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850543105",
            "telephone_number": "602-467-4966",
            "fax_number": "480-419-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVIN",
        "first_name": "JONATHAN",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-26",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "51173",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.