Individual provider Active NPI

Preston Todd Summerhays, OD

  • Optometrist
  • Surprise, AZ
National Provider Identifier
1326614272
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-002487 Issued in AZ
Practice address
13945 W Grand Ave # A101
Surprise, AZ 85374-2437
Phone
(623) 931-2943
NPI assigned
Jun 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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-002487 AZ Primary

Addresses

Primary practice location

13945 W Grand Ave # A101
Surprise, AZ 85374-2437

Mailing address

10245 W Daley LN
Peoria, AZ 85383-2737
Phone (801) 654-3341

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
I20210618001068 AZ Practitioner - Optometry 4880094457 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2021
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)

13125 N la Montana Dr
Suite 1
Fountain Hills, AZ 85268-3781
Phone (480) 816-0102

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-002487AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
John H McDougall OD Arizona PC Optometrist CurrentSince Feb 12, 2024 Accepting new patients
Valley Vision Care LLC Optometrist CurrentSince Jun 30, 2021 Accepting new patients
John R Tanner OD PLLC Optometrist CurrentSince Jan 30, 2023 Accepting new patients
Gary L Morgan OD PC Optometrist Past Accepting new patients

Locations

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

18431 N 91st Ave
Ste 1
Peoria, AZ 85382
Phone (623) 393-8324

13945 W Grand Ave
Ste A101
Surprise, AZ 85374
Phone (623) 537-5170

Interoperability endpoints

  • Direct secure messaging: psummerhays@tvec.intellechartdirect.net

Organizations & group practices 4

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": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1326614272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10245 W DALEY LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853832737",
            "telephone_number": "801-654-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13945 W GRAND AVE # A101",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742437",
            "telephone_number": "623-931-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERHAYS",
        "first_name": "PRESTON",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.