Individual provider Active NPI

Riley Williamson, O.D.

  • Optometrist
  • Green Valley, AZ
National Provider Identifier
1407118169
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1887 Issued in AZ
Practice address
560 E Continental Road
Suite 104
Green Valley, AZ 85614
Phone
(520) 625-5673
Fax
(520) 625-6259
NPI assigned
Jun 8, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1887 AZ Primary

Addresses

Primary practice location

560 E Continental Road
Suite 104
Green Valley, AZ 85614

Mailing address

560 E Continental Road
Suite 104
Green Valley, AZ 85614
Phone (520) 625-5673

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
I20121121000378 AZ Practitioner - Optometry 4789831579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista Eye Care, PLCGroup PAC ID 6406955731, 9 clinicians

Practice addresses (Care Compare)

560 E Continental Rd
Unit 104
Green Valley, AZ 85614-1825
Phone (520) 625-5673

Merit-based Incentive Payment System (MIPS)

Final score
97.5 of 100Reported as individual
Quality
95
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1887AZMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Eye Care, PLC Optometrist CurrentSince Nov 30, 2015 Accepting new patients
Eye Center of Brookings, LLC Optometrist PastSince Jan 1, 2002 Accepting new patients
Catalina Eye Care PC PastSince Nov 30, 2015 Accepting new patients
Nationwide Optometry P.C. Optometrist Past Accepting new patients

Locations

560 E Continental Rd
Unit 104
Green Valley, AZ 85614
Phone (520) 576-5110

8140 S Houghton Rd
Ste 140
Tucson, AZ 85747
Phone (520) 664-9801

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": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1407118169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 E CONTINENTAL ROAD",
            "address_2": "SUITE 104",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "85614",
            "telephone_number": "520-625-5673",
            "fax_number": "520-625-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 E CONTINENTAL ROAD",
            "address_2": "SUITE 104",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "85614",
            "telephone_number": "520-625-5673",
            "fax_number": "520-625-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "RILEY",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-08",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

Verify at the official NPI Registry.