Individual provider Active NPI

Patricia R Bogaard, O.D.

  • Optometrist
  • Surprise, AZ
National Provider Identifier
1255378279
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2163 Issued in AZ
Practice address
15341 W Waddell Rd Ste 106
Surprise, AZ 85379-5169
Phone
(623) 544-7800
NPI assigned
May 31, 2006
Last updated
Oct 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2163 AZ Primary
Optometrist 152W00000X 2001022272 MO
Optometrist 152W00000X 622 SD

Addresses

Primary practice location

15341 W Waddell Rd Ste 106
Surprise, AZ 85379-5169

Mailing address

26520 Network PL
Chicago, IL 60673-1265
Phone (623) 537-6000

Other practice location 1

5865 W Utopia Rd
Glendale, AZ 85308-5251
Phone (623) 537-6000

Other identifiers 2

IdentifierTypeStateIssuer
9203570MedicaidSD
G49B00001OtherMOMEDICARE PTAN

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
I20170213002373 AZ Practitioner - Optometry 7911891254 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steven R Holt OD PLLCGroup PAC ID 6305071994, 2 clinicians
Midwestern UniversityGroup PAC ID 6305734773, 116 clinicians

Practice addresses (Care Compare)

15557 W Bell Rd
Suite 410
Surprise, AZ 85374-3059
Phone (623) 544-7800

5865 W Utopia Rd
Glendale, AZ 85308-5251
Phone (623) 537-6000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2163AZMDOptometrist
622SDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwestern University Optometrist CurrentSince Jan 3, 2024 Accepting new patients
Steven R Holt OD PLLC Optometrist CurrentSince Jun 1, 2020 Accepting new patients
Midwestern University Optometrist CurrentSince Jan 3, 2024 Accepting new patients
Bogaard and Associates, LLC Optometrist PastSince Feb 9, 2004 Accepting new patients
Midwestern University Optometrist Past Accepting new patients

Locations

19389 N 59th Ave
Glendale, AZ 85308

5865 W Utopia Rd
Glendale, AZ 85308
Phone (623) 806-7200

15341 W Waddell Rd
Ste 106
Surprise, AZ 85379
Phone (623) 544-7800

15557 W Bell Rd
Ste 410
Surprise, AZ 85374
Phone (623) 544-7800

26520 Network Pl
Chicago, IL 60673
Phone (630) 743-4500

Organizations & group practices 5

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1255378279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26520 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731265",
            "telephone_number": "623-537-6000",
            "fax_number": "623-806-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15341 W WADDELL RD STE 106",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853795169",
            "telephone_number": "623-544-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5865 W Utopia Rd",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853085251",
            "country_code": "US",
            "telephone_number": "623-537-6000",
            "fax_number": "623-806-7210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGAARD",
        "first_name": "PATRICIA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2163",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2001022272",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SD",
            "license": "622",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9203570",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G49B00001",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.