Organization Active NPI

Desert Eyesthetics PC

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Gilbert, AZ
National Provider Identifier
1184076028
Registry record updated Jul 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
41599 Issued in AZ
Legal business name
DESERT EYESTHETICS PC
Practice address
1754 E Boston St
Suite 103
Gilbert, AZ 85295-6238
Phone
(480) 454-7130
Fax
(480) 454-7135
NPI assigned
Jul 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2016

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

Authorized official

Name
Dr. Denise Dealva Garcia, MDNPI 1194885590
Title
President
Phone
(480) 370-1076

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
Ophthalmic Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207WX0200X 41599 AZ Primary

Addresses

Primary practice location

1754 E Boston St
Suite 103
Gilbert, AZ 85295-6238

Mailing address

1754 E Boston St
Suite 103
Gilbert, AZ 85295-6238
Phone (480) 454-7130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160818001621 AZ Part B Supplier - Clinic/Group Practice 7214222066 Receives reassigned benefits from 1 practitioner
Practice locations: Gilbert, AZ

National Provider Directory

National Provider Directory

Locations

1754 E Boston St
Ste 103
Gilbert, AZ 85295
Phone (480) 454-7130

1114 S Higley Rd
Mesa, AZ 85206
Phone (480) 264-2295

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": "1467590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467590400000",
    "number": "1184076028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1754 E BOSTON ST",
            "address_2": "SUITE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956238",
            "telephone_number": "480-454-7130",
            "fax_number": "480-454-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1754 E BOSTON ST",
            "address_2": "SUITE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852956238",
            "telephone_number": "480-454-7130",
            "fax_number": "480-454-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT EYESTHETICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-04",
        "last_updated": "2016-07-04",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "DEALVA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-370-1076",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "AZ",
            "license": "41599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2016; 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.