Jack Owens Sipperley, MD

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

16167 Issued in AZ

Practice address

4800 N 22ND St
Phoenix, AZ 85016-4701

Phone

(602) 955-1000

Fax

(602) 508-4830

NPI assigned

Aug 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of Miami, LM Miller School of Medicine, 1971

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)

Hospital & facility affiliations

• Havasu Regional Medical Center Hospital, Lake Havasu City, AZ, CCN 030069

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

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 31)

Interoperability endpoints

• Direct secure messaging: jack.sipperley@direct.avp.nextgenshare.com

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.

• Barnet Dulaney Perkins Eye Center, PC

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1376574707
  Medicare reassignment Care Compare group NPD
• Southwestern Eye Center LTD

  • Ophthalmology Physician
  • Scottsdale, AZ
  • NPI 1023063187
  Medicare reassignment NPD
• Barnet Dulaney Perkins Eye Center, PC

  • Ophthalmology Physician
  • Cottonwood, AZ
  • NPI 1013952522
  NPD
• Barnet Dulaney Perkins Eye Center, PC

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
  • NPI 1043910078
  NPD
• Southwestern Eye Center, LTD

  • Durable Medical Equipment & Medical Supplies
  • Tempe, AZ
  • NPI 1558102608
  NPD
• Arizona Foundation for the Changing Eye, Inc.

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1639108335
  NPD (past)
• Barnet Dulaney Perkins Eye Center, PC

  • Ambulatory Surgical Clinic/Center
  • Lake Havasu City, AZ
  • NPI 1497727093
  NPD (past)
• Eyenet Triage, PLC

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1932553211
  NPD (past)
• Retinal Consultants of Arizona LTD

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1700823051
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Havasu Regional Medical Center LLC

  • Rural Acute Care Hospital
  • Lake Havasu City, AZ
  • NPI 1780761866
  Care Compare affiliation

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1235130402",
    "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": "4800 N 22ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164701",
            "telephone_number": "602-955-1000",
            "fax_number": "602-508-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPPERLEY",
        "first_name": "JACK",
        "middle_name": "OWENS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "16167",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "AZ",
            "license": "16167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285412",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sip Home Systems - Mesa LLC
• Sip Home Systems - Sun City LLC
• Michelle Vita Sipe, M.D.
• Keri Sipek, M.A.
• Brenda Lue Sipes, M.D.
• Athanasia Sipsas-Herrmann, PH.D.
• Siren Medical PC
• Siri Priyam, LLC
• Daria Siriano
• Shantipriya Siripurapu, MD

• Retina Specialist (Ophthalmology) Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Retina Specialist (Ophthalmology) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.