Individual provider Active NPI

Michael Jeffrey Girardin, OD

  • Optometrist
  • Tucson, AZ
National Provider Identifier
1417873092
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002975 Issued in AZ
Practice address
3788 S 16TH Ave
Tucson, AZ 85713-6079
Phone
(520) 388-9741
Fax
(520) 388-9750
NPI assigned
Jun 26, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 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 OPT002975 AZ Primary

Addresses

Primary practice location

3788 S 16TH Ave
Tucson, AZ 85713-6079

Mailing address

955 W Southern Ave Ste 101
Mesa, AZ 85210-4903
Phone (480) 961-1865

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1782432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1417873092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W SOUTHERN AVE STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104903",
            "telephone_number": "480-961-1865",
            "fax_number": "480-893-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3788 S 16TH AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857136079",
            "telephone_number": "520-388-9741",
            "fax_number": "520-388-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIRARDIN",
        "first_name": "MICHAEL",
        "middle_name": "JEFFREY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-26",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT002975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.