Individual provider Active NPI

Alexandra Levashvili, O.D.

  • Optometrist
  • Surprise, AZ
National Provider Identifier
1174909923
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG002963 Issued in PA
Practice address
12647 W Smokey Dr Ste 116
Surprise, AZ 85378-3799
Phone
(623) 583-0377
Fax
(623) 583-0377
NPI assigned
Aug 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG002963 PA Primary

Addresses

Primary practice location

12647 W Smokey Dr Ste 116
Surprise, AZ 85378-3799

Mailing address

12647 W Smokey Dr Ste 116
Surprise, AZ 85378-3799
Phone (623) 583-0377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150916000070 PA Practitioner - Optometry 7810204385 Reassigns benefits to 3 organizations
I20260319001990 AZ Practitioner - Optometry 7810204385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keen Eye Center LLCGroup PAC ID 2466805098, 2 clinicians
Jason D Munitz OD LLCGroup PAC ID 8426337262, 3 clinicians

Practice addresses (Care Compare)

12647 W Smokey Dr
Suite 116
Surprise, AZ 85378-3799
Phone (623) 583-0377

295 Buck Rd
Suite 316
Holland, PA 18966-1750
Phone (215) 953-1200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG002963PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tus Ojos Inc Optometrist CurrentSince May 1, 2024 Accepting new patients
Visionworks, Inc CurrentSince Jan 29, 2019 Accepting new patients
Keen Eye Center LLC Optometrist CurrentSince Mar 9, 2026 Accepting new patients
Jason D Munitz OD LLC Optometrist CurrentSince Jan 27, 2025 Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Jan 29, 2019 Accepting new patients

Locations

12801 W Bell Rd
Ste 139
Surprise, AZ 85378
Phone (480) 980-4238

560 Millcreek Mall
Erie, PA 16565
Phone (814) 868-8540

2300 E Lincoln Hwy
Langhorne, PA 19047
Phone (215) 750-3760

412 W Lehigh Ave
Philadelphia, PA 19133
Phone (215) 425-0124

295 Buck Rd
Ste 316
Southampton, PA 18966
Phone (215) 953-1200

Organizations & group practices 5

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": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1174909923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12647 W SMOKEY DR STE 116",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853783799",
            "telephone_number": "623-583-0377",
            "fax_number": "623-583-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12647 W SMOKEY DR STE 116",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853783799",
            "telephone_number": "623-583-0377",
            "fax_number": "623-583-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVASHVILI",
        "first_name": "ALEXANDRA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.