Individual provider Active NPI

Susan L Kaplan, O.D.

  • Optometrist
  • Glendale, AZ
National Provider Identifier
1184726176
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
683 Issued in AZ
Practice address
19420 N 59TH Ave
Suite E-525
Glendale, AZ 85308-6894
Phone
(602) 843-2900
Fax
(602) 843-0233
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 683 AZ Primary

Addresses

Primary practice location

19420 N 59TH Ave
Suite E-525
Glendale, AZ 85308-6894

Mailing address

19420 N 59TH Ave
Suite E-525
Glendale, AZ 85308-6894
Phone (602) 843-2900

Other identifiers 1

IdentifierTypeStateIssuer
AZ0902300OtherAZBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
683AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eyecare Associates of Az PLC Optometrist Past Accepting new patients
Family Eyecare of Scottsdale, PLC Optometrist PastSince Jul 1, 2009 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1184726176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19420 N 59TH AVE",
            "address_2": "SUITE E-525",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086894",
            "telephone_number": "602-843-2900",
            "fax_number": "602-843-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19420 N 59TH AVE",
            "address_2": "SUITE E-525",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086894",
            "telephone_number": "602-843-2900",
            "fax_number": "602-843-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPLAN",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0902300",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.