Individual provider Active NPI

Bradley Bywater, O.D.

  • Optometrist
  • Mesa, AZ
National Provider Identifier
1407159890
Registry record updated May 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-001783 Issued in AZ
Practice address
1517 S Signal Butte Rd
Mesa, AZ 85209-1630
Phone
(602) 308-2102
NPI assigned
Dec 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2026

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-001783 AZ Primary

Addresses

Primary practice location

1517 S Signal Butte Rd
Mesa, AZ 85209-1630

Mailing address

607 W Desert Seasons Dr
San Tan Valley, AZ 85143-3431
Phone (971) 678-7507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

220 N McKemy Ave
Chandler, AZ 85226-2654

607 W Desert Seasons Dr
San Tan Valley, AZ 85143-3431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1783AZMDGeneral Practice Dentistry
OPT-001783AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Valley Eye Care Optometrist Current Accepting new patients
Nationwide Optometry P.C. Optometrist Past Accepting new patients
Nationwide Optometry P.C. Optometrist PastSince Sep 1, 2022 Accepting new patients
Nationwide Optometry P.C. Optometrist Past Accepting new patients

Locations

1517 S Signal Butte Rd
Mesa, AZ 85209
Phone (480) 627-2086

Interoperability endpoints

  • Direct secure messaging: dr.bradley.bywater@direct.eyecare-partners.com

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, 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": "1291680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778889600000",
    "number": "1407159890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W DESERT SEASONS DR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851433431",
            "telephone_number": "971-678-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 S SIGNAL BUTTE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852091630",
            "telephone_number": "602-308-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYWATER",
        "first_name": "BRADLEY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-07",
        "last_updated": "2026-05-16",
        "certification_date": "2026-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-001783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.