Individual provider Active NPI

Michelle Jacqueline Nadeau, O.D.

  • Optometrist
  • Scottsdale, AZ
National Provider Identifier
1255614178
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-002412 Issued in AZ
Practice address
9336 E Raintree Dr Ste 140
Scottsdale, AZ 85260-7323
Phone
(480) 614-0055
NPI assigned
Sep 27, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT-002412 AZ Primary

Addresses

Primary practice location

9336 E Raintree Dr Ste 140
Scottsdale, AZ 85260-7323

Mailing address

9336 E Raintree Dr Ste 140
Scottsdale, AZ 85260-7323
Phone (480) 614-0055

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
I20200414002072 AZ Practitioner - Optometry 7911174206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John H McDougall OD Arizona PCGroup PAC ID 3274880117, 44 clinicians

Practice addresses (Care Compare)

9336 E Raintree Dr
Suite 140
Scottsdale, AZ 85260-7323
Phone (480) 614-0055

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-002412AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
John H McDougall OD Arizona PC Optometrist CurrentSince Feb 8, 2020 Accepting new patients

Locations

13125 N La Montana Dr
Ste 1
Fountain Hls, AZ 85268
Phone (480) 816-0102

6239 E Brown Rd
Ste 113
Mesa, AZ 85205
Phone (480) 218-0663

9336 E Raintree Dr
Ste 140
Scottsdale, AZ 85260
Phone (480) 614-0055

1200 E Campbell Rd
Ste 108
Richardson, TX 75081
Phone (972) 370-5552

Organizations & group practices 1

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": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1255614178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9336 E RAINTREE DR STE 140",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852607323",
            "telephone_number": "480-614-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9336 E RAINTREE DR STE 140",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852607323",
            "telephone_number": "480-614-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADEAU",
        "first_name": "MICHELLE",
        "middle_name": "JACQUELINE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.