Scottsdale Eye Surgery Center, P.C

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

OSC0047 Issued in AZ

Legal business name

SCOTTSDALE EYE SURGERY CENTER, P.C

Practice address

8414 N 90TH St
Scottsdale, AZ 85258-4395

Phone

(480) 949-1208

Fax

(480) 994-3316

NPI assigned

Dec 14, 2005

Organization subpart

No

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

Authorized official

Name

Miss Joyce R. Schweikert, MBA

Title

Administrator

Phone

(480) 291-7963

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

Scottsdale Eye Surgery Center PCCCN 03C0001063

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 2

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

• Paul M Petelin Jr., MD

  • Ophthalmology Physician
  • Scottsdale, AZ
  • NPI 1245328871
  NPD
• Dustin Michael Heringer, MD

  • Ophthalmology Physician
  • Tucson, AZ
  • NPI 1124074190
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557705600000",
    "number": "1295710002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8414 N 90TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584395",
            "telephone_number": "480-949-1208",
            "fax_number": "480-994-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8414 N 90TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584395",
            "telephone_number": "480-949-1208",
            "fax_number": "480-994-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTSDALE EYE SURGERY CENTER, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-14",
        "last_updated": "2019-05-13",
        "status": "A",
        "authorized_official_last_name": "SCHWEIKERT",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "480-291-7963",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC0047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z3C0001063",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062688",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scottsdale Emergency Associates, LTD.
• Scottsdale Endoscopy ASC LLC
• Scottsdale Endoscopy Center PLC
• Scottsdale Eye Institute, PLC
• Scottsdale Eye Physicians & Surgeons PC
• Scottsdale Facial & Oral Surgery LLC
• Scottsdale Facial Aesthetics PLLC
• Scottsdale Family & Urgent Care
• Scottsdale Family Dental P.L.L.C.
• Scottsdale Family Health, PLLC

• All providers in Scottsdale, AZ
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; 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.