Individual provider Active NPI

Roger Alejandro Juarez, O.D.

  • Optometrist
  • Phoenix, AZ
National Provider Identifier
1154587939
Registry record updated May 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13576 Issued in CA
Practice address
9515 W Camelback Rd
Suite 110
Phoenix, AZ 85037-1355
Phone
(623) 937-1655
Fax
(623) 930-1396
NPI assigned
Jul 31, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13576 CA Primary

Addresses

Primary practice location

9515 W Camelback Rd
Suite 110
Phoenix, AZ 85037-1355

Mailing address

9515 W Camelback Rd
Suite 110
Phoenix, AZ 85037-1355
Phone (623) 937-1655

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110214000141 AZ Practitioner - Optometry 6103014329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9515 W Camelback Rd
Suite 110
Phoenix, AZ 85037-1365
Phone (623) 937-1655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13576CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Vision Center of West Phoenix Optometrist CurrentSince Oct 13, 2010 Accepting new patients
Dr. Burns & Associates, P.C. Optometrist Past Accepting new patients

Locations

9515 W Camelback Rd
Ste 110
Phoenix, AZ 85037
Phone (623) 937-1655

10265 W Camelback Rd
Ste 130
Phoenix, AZ 85037
Phone (623) 937-1655

Organizations & group practices 2

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": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400112000000",
    "number": "1154587939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9515 W CAMELBACK RD",
            "address_2": "SUITE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371355",
            "telephone_number": "623-937-1655",
            "fax_number": "623-930-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9515 W CAMELBACK RD",
            "address_2": "SUITE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371355",
            "telephone_number": "623-937-1655",
            "fax_number": "623-930-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "ROGER",
        "middle_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2014-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.