NPIMap

Organization Active NPI

Troy S Ford OD PC

Doing business as Payson Eye Care Center

  • Optometrist
  • Payson, AZ
National Provider Identifier
1275722498
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD790 Issued in AZ
Legal business name
TROY S FORD OD PC
Doing business as
Payson Eye Care Center
Practice address
411 S Beeline Hwy
Suite a
Payson, AZ 85541-4892
Phone
(928) 474-3556
Fax
(928) 474-3161
NPI assigned
Oct 24, 2007
Last updated
Sep 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Authorized official

Name
Dr. Troy S Ford, ODNPI 1730259227
Title
President
Phone
(928) 474-3556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD790 AZ Primary

Addresses

Primary practice location

411 S Beeline Hwy
Suite a
Payson, AZ 85541-4892

Mailing address

411 S Beeline Hwy
Suite a
Payson, AZ 85541-4892
Phone (928) 474-3556

Other identifiers 1

IdentifierTypeStateIssuer
101254MedicaidAZ

Other names 1

  • Payson Eye Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040615001212 AZ Part B Supplier - Clinic/Group Practice 1456335702 Receives reassigned benefits from 2 practitioners
Practice locations: Payson, AZ
O20100930041371 AZ DME Supplier - Physician - Optometrist 1456335702 Practice locations: Payson, 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
Troy S Ford OD PC411 S Beeline Hwy, Payson, AZ 85541-4892(928) 474-3556 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jul 22, 2002

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1275722498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 S BEELINE HWY",
            "address_2": "SUITE A",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855414892",
            "telephone_number": "928-474-3556",
            "fax_number": "928-474-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S BEELINE HWY",
            "address_2": "SUITE A",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855414892",
            "telephone_number": "928-474-3556",
            "fax_number": "928-474-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TROY S FORD OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-474-3556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OD790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101254",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Payson Eye Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Payson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; 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.