Individual provider Active NPI

Christine Fahmy, OD

  • Optometrist
  • Queen Creek, AZ
National Provider Identifier
1376315077
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-002753 Issued in AZ
Practice address
21321 E Ocotillo Rd Ste 105
Queen Creek, AZ 85142-5993
Phone
(480) 656-7739
NPI assigned
Oct 25, 2023
Last updated
Oct 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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-002753 AZ Primary

Addresses

Primary practice location

21321 E Ocotillo Rd Ste 105
Queen Creek, AZ 85142-5993

Mailing address

20954 E Mayberry Rd
Queen Creek, AZ 85142-3825

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
I20250116000886 AZ Practitioner - Optometry 4587192687 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Tan Eyecare PLCGroup PAC ID 1456420140, 3 clinicians
John N Chrisagis O D P CGroup PAC ID 6406832997, 4 clinicians

Practice addresses (Care Compare)

2680 S Val Vista Dr
Suite 111
Gilbert, AZ 85295-1606
Phone (480) 807-0288

7511 S McClintock Dr
Tempe, AZ 85283-5041
Phone (480) 967-4910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
San Tan Eyecare PLC Optometrist CurrentSince Dec 14, 2024 Accepting new patients
John N Chrisagis O D P C Optometrist CurrentSince Dec 8, 2025 Accepting new patients

Locations

2680 S Val Vista Dr
Ste 111
Gilbert, AZ 85295
Phone (480) 648-0950

7511 S McClintock Dr
Tempe, AZ 85283
Phone (480) 967-4910

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1376315077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20954 E MAYBERRY RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851423825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD STE 105",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425993",
            "telephone_number": "480-656-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHMY",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.