Individual provider Active NPI

Ric R Rios, OD

  • Optometrist
  • Phoenix, AZ
National Provider Identifier
1194805481
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
536 Issued in AZ
Practice address
12450 N 32ND St
Phoenix, AZ 85032-7160
Phone
(602) 494-0054
Fax
(602) 788-8431
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 536 AZ Primary

Addresses

Primary practice location

12450 N 32ND St
Phoenix, AZ 85032-7160

Mailing address

12450 N 32ND St
Phoenix, AZ 85032-7160
Phone (602) 494-0054

Other identifiers 1

IdentifierTypeStateIssuer
4835450001MedicaidAZ

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
I20101208000246 AZ Practitioner - Optometry 1759374077 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15600 N Black Canyon Hwy
Suite C102
Phoenix, AZ 85053-4055
Phone (602) 661-7006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
536AZMDHome Health Registered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenician Eye Specialists CurrentSince Mar 1, 2022 Accepting new patients
Personal Eyes LLC Optometrist CurrentSince May 5, 2022 Accepting new patients
Eyes on Hayden, PLLC Optometrist PastSince Aug 18, 2019 Accepting new patients

Locations

12450 N 32nd St
Ste 1
Phoenix, AZ 85032
Phone (602) 494-0054

15600 N Black Canyon Hwy
Ste C102
Phoenix, AZ 85053
Phone (602) 661-7006

12450 N 32nd St
Phoenix, AZ 85032
Phone (602) 494-0054

15600 N Black Canyon Hwy
#C102
Phoenix, AZ 85053
Phone (623) 232-2762

15033 W Bell Rd
Ste 150
Surprise, AZ 85374
Phone (623) 232-2762

Organizations & group practices 3

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1194805481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12450 N 32ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850327160",
            "telephone_number": "602-494-0054",
            "fax_number": "602-788-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 N 32ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850327160",
            "telephone_number": "602-494-0054",
            "fax_number": "602-788-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIOS",
        "first_name": "RIC",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4835450001",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.