Organization Active NPI

Family Eyecare of Scottsdale, PLC

  • Optometrist
  • Scottsdale, AZ
National Provider Identifier
1356576052
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
12 Issued in AZ
Legal business name
FAMILY EYECARE OF SCOTTSDALE, PLC
Practice address
9815 E Bell Rd
Suite 105
Scottsdale, AZ 85260-2341
Phone
(480) 419-3900
Fax
(480) 419-3943
NPI assigned
May 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Authorized official

Name
Dr. Stuart G Bark, OD
Title
Owner
Phone
(480) 419-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 12 AZ Primary

Addresses

Primary practice location

9815 E Bell Rd
Suite 105
Scottsdale, AZ 85260-2341

Mailing address

9815 E Bell Rd
Suite 105
Scottsdale, AZ 85260-2341
Phone (480) 419-3900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090910000297 AZ Part B Supplier - Clinic/Group Practice 8325193600 Receives reassigned benefits from 3 practitioners
Practice locations: Scottsdale, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337126400000",
    "number": "1356576052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9815 E BELL RD",
            "address_2": "SUITE 105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602341",
            "telephone_number": "480-419-3900",
            "fax_number": "480-419-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9815 E BELL RD",
            "address_2": "SUITE 105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602341",
            "telephone_number": "480-419-3900",
            "fax_number": "480-419-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYECARE OF SCOTTSDALE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2012-05-16",
        "status": "A",
        "authorized_official_last_name": "BARK",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-419-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; 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.