Organization Active NPI

Total Eyecare Center, PC

  • Optometrist
  • Tempe, AZ
National Provider Identifier
1396905170
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
714 Issued in AZ
Legal business name
TOTAL EYECARE CENTER, PC
Practice address
4015 S McClintock Dr
Suite 107
Tempe, AZ 85282-5877
Phone
(480) 345-0090
Fax
(480) 345-7094
NPI assigned
Jun 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Dr. Doyle D. Holle, O.D.NPI 1164484499
Title
President/Optometrist
Phone
(480) 345-0090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 714 AZ Primary
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X 714 AZ
Pediatric OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WP0200X 714 AZ
Sports Vision OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WS0006X 714 AZ
Occupational Vision OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WX0102X 714 AZ

Addresses

Primary practice location

4015 S McClintock Dr
Suite 107
Tempe, AZ 85282-5877

Mailing address

4015 S McClintock Dr
Suite 107
Tempe, AZ 85282-5877
Phone (480) 345-0090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091113000229 AZ Part B Supplier - Clinic/Group Practice 2567426315 Receives reassigned benefits from 1 practitioner
Practice locations: Tempe, AZ

National Provider Directory

National Provider Directory

Locations

1002 E Missouri Ave
#301
Phoenix, AZ 85014
Phone (602) 263-0850

4015 S McClintock Dr
Ste 107
Tempe, AZ 85282
Phone (480) 345-0090

Practitioners & affiliated clinicians

Practitioners 1

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": "1213401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1396905170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 S MCCLINTOCK DR",
            "address_2": "SUITE 107",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825877",
            "telephone_number": "480-345-0090",
            "fax_number": "480-345-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 S MCCLINTOCK DR",
            "address_2": "SUITE 107",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825877",
            "telephone_number": "480-345-0090",
            "fax_number": "480-345-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL EYECARE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-14",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "HOLLE",
        "authorized_official_first_name": "DOYLE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "480-345-0090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "714",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "AZ",
            "license": "714",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "AZ",
            "license": "714",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": "AZ",
            "license": "714",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Occupational Vision",
            "state": "AZ",
            "license": "714",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.