Individual provider Active NPI

Mary V Fisher, OD

  • Optometrist
  • Goodyear, AZ
National Provider Identifier
1184610784
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0808 Issued in AZ
Practice address
1626 N Litchfield Rd Ste 110
Goodyear, AZ 85395-1399
Phone
(602) 955-1000
Fax
(602) 508-4830
NPI assigned
Sep 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0808 AZ Primary

Addresses

Primary practice location

1626 N Litchfield Rd Ste 110
Goodyear, AZ 85395-1399

Mailing address

4800 N 22ND St
Phoenix, AZ 85016-4701
Phone (602) 955-1000

Other identifiers 1

IdentifierTypeStateIssuer
0808OtherAZSTATE LICENSE

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
I20140813002008 AZ Practitioner - Optometry 1850371659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnet Dulaney Perkins Eye Center, PCGroup PAC ID 0749288298, 104 clinicians

Practice addresses (Care Compare)

1626 N Litchfield Rd
Suite 110
Goodyear, AZ 85395-1399
Phone (602) 955-1000

Merit-based Incentive Payment System (MIPS)

Final score
83.86 of 100Reported as group
Quality
81.82
Promoting interoperability
100
Improvement activities
40
Cost
64.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0808AZMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Barnet Dulaney Perkins Eye Center, PC CurrentSince Aug 1, 2014 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC CurrentSince Aug 1, 2014 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC Past Accepting new patients
Kent Vision Centers Inc Optometrist Past Accepting new patients

Locations

855 S Dobson Rd
Ste 1
Chandler, AZ 85224

1626 N Litchfield Rd
Ste 110
Goodyear, AZ 85395
Phone (817) 995-2500

5250 E Southern Ave
Mesa, AZ 85206
Phone (480) 420-1005

4800 N 22nd St
Phoenix, AZ 85016
Phone (602) 508-4843

4800 N 22nd St
Ste 120
Phoenix, AZ 85016

14820 N Del Webb Blvd
Sun City, AZ 85351

9425 W Bell Rd
Sun City, AZ 85351
Phone (602) 956-9866

14239 W Bell Rd
Ste 216
Surprise, AZ 85374

14239 W Bell Rd
Ste 216219
Surprise, AZ 85374

Interoperability endpoints

  • Direct secure messaging: mary.fisher@direct.avp.nextgenshare.com

Organizations & group practices 4

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1184610784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N 22ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164701",
            "telephone_number": "602-955-1000",
            "fax_number": "602-508-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 N LITCHFIELD RD STE 110",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951399",
            "telephone_number": "602-955-1000",
            "fax_number": "602-508-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "MARY",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "0808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0808",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.