Individual provider Active NPI

Nicole McConnell, OD

  • Optometrist
  • Goodyear, AZ
National Provider Identifier
1285421297
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-002943 Issued in AZ
Practice address
16918 W Beth Dr
Goodyear, AZ 85338-4740
Phone
(623) 606-1510
NPI assigned
Apr 22, 2025
Last updated
Jul 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-002943 AZ Primary

Addresses

Primary practice location

16918 W Beth Dr
Goodyear, AZ 85338-4740

Mailing address

7071 N 138TH Ave BLDG 1540
Glendale, AZ 85307-2006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

16918 W Beth Dr
Goodyear, AZ 85338-4740

5691 Rickenbacker Rd
Nellis AFB, NV 89191-7087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1285421297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7071 N 138TH AVE BLDG 1540",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853072006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16918 W BETH DR",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853384740",
            "telephone_number": "623-606-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "NICOLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-22",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.