NPIMap

Organization Active NPI

Nationwide Optometry P.C.

  • Optometrist
  • Queen Creek, AZ
National Provider Identifier
1194468561
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
NATIONWIDE OPTOMETRY P.C.
Practice address
24921 S Ellsworth Rd Ste 140
Queen Creek, AZ 85142-1579
Phone
(480) 564-2682
Fax
(480) 564-2683
NPI assigned
Apr 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Authorized official

Name
Jarrod Cross, OD
Title
President
Phone
(509) 201-0051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

24921 S Ellsworth Rd Ste 140
Queen Creek, AZ 85142-1579

Mailing address

955 W Southern Ave Ste 101
Mesa, AZ 85210-4903
Phone (480) 961-1865

Other names 1

  • Nationwide Vision Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240606000553 AZ DME Supplier - Physician - Optometrist 6901033075 Practice locations: Queen Creek, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Nationwide Vision24921 S Ellsworth Rd, Queen Creek, AZ 85142-1579(480) 564-2682 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Oct 1, 2013

National Provider Directory

National Provider Directory
Tax ID family
Nationwide Vision Cente18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

24921 S Ellsworth Rd
Ste 130
Queen Creek, AZ 85142

NPI Registry JSON

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1194468561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W SOUTHERN AVE STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104903",
            "telephone_number": "480-961-1865",
            "fax_number": "480-893-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24921 S ELLSWORTH RD STE 140",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421579",
            "telephone_number": "480-564-2682",
            "fax_number": "480-564-2683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONWIDE OPTOMETRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "JARROD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-201-0051",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nationwide Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nationwide Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.