Organization Active NPI

Sonoran Desert Eye Center, LLC

  • Optometrist
  • Chandler, AZ
National Provider Identifier
1285809913
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
945 Issued in AZ
Legal business name
SONORAN DESERT EYE CENTER, LLC
Practice address
2211 E Pecos Rd
1
Chandler, AZ 85225-6142
Phone
(480) 812-2211
NPI assigned
Apr 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Authorized official

Name
Tiffany Quaranta
Title
Office Manager
Phone
(480) 812-2211

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 945 AZ Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

2211 E Pecos Rd
1
Chandler, AZ 85225-6142

Mailing address

2211 E Pecos Rd
1
Chandler, AZ 85225-6142
Phone (480) 812-2211

Other identifiers 1

IdentifierTypeStateIssuer
AZ0945OtherAZSTATE OF ARIZONA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080722000124 AZ Part B Supplier - Clinic/Group Practice 4789757972 Receives reassigned benefits from 2 practitioners
Practice locations: Chandler, AZ

National Provider Directory

National Provider Directory

Locations

2211 E Pecos Rd
Ste 1
Chandler, AZ 85225
Phone (480) 812-2211

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548115200000",
    "number": "1285809913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 E PECOS RD",
            "address_2": "1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852256142",
            "telephone_number": "480-812-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 E PECOS RD",
            "address_2": "1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852256142",
            "telephone_number": "480-812-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONORAN DESERT EYE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2019-01-22",
        "status": "A",
        "authorized_official_last_name": "QUARANTA",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "480-812-2211"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "945",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ARIZONA",
            "identifier": "AZ0945",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.