Active NPI
Bradley Bywater, O.D.
- Optometrist
- Mesa, AZ
National Provider Identifier
1407159890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT-001783
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1783 | AZ | MD | General Practice Dentistry |
| OPT-001783 | AZ | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Desert Valley Eye Care | Optometrist | Current | Accepting new patients |
| Nationwide Optometry P.C. | Optometrist | Past | Accepting new patients |
| Nationwide Optometry P.C. | Optometrist | Past | 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
- 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.
-
- Optometrist
- Mesa, AZ
- NPI 1023957842
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.