Individual provider Active NPI

Steven R Holt, OD

  • Optometrist
  • Surprise, AZ
National Provider Identifier
1417936014
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1305 Issued in AZ
Practice address
15341 W Waddell Rd # 106
Surprise, AZ 85379
Phone
(623) 932-2020
Fax
(623) 932-2668
NPI assigned
Jan 11, 2006
Last updated
Dec 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1305 AZ Primary

Addresses

Primary practice location

15341 W Waddell Rd # 106
Surprise, AZ 85379

Mailing address

15341 W Waddell Rd Ste 106
Surprise, AZ 85379-5169
Phone (623) 544-7800

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
I20031222000444 AZ Practitioner - Optometry 3476451972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steven R Holt OD PLLCGroup PAC ID 6305071994, 2 clinicians

Practice addresses (Care Compare)

15557 W Bell Rd
Suite 410
Surprise, AZ 85374-3059
Phone (623) 544-7800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1305AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Steven R Holt OD PLLC Optometrist CurrentSince Jun 27, 2013 Accepting new patients

Locations

15341 W Waddell Rd
Ste 106
Surprise, AZ 85379
Phone (623) 544-7800

15557 W Bell Rd
Ste 410
Surprise, AZ 85374
Phone (623) 544-7800

Organizations & group practices 1

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1417936014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15341 W WADDELL RD STE 106",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853795169",
            "telephone_number": "623-544-7800",
            "fax_number": "623-544-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15341 W WADDELL RD # 106",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85379",
            "telephone_number": "623-932-2020",
            "fax_number": "623-932-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "STEVEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.