Individual provider Active NPI

Joseph Taddonio, O.D.

  • Optometrist
  • Glendale, AZ
National Provider Identifier
1417946989
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
233 Issued in AZ
Practice address
5026 W Cactus Rd
Suite 4
Glendale, AZ 85304-2241
Phone
(602) 547-9124
Fax
(602) 547-9634
NPI assigned
Oct 18, 2005
Last updated
May 5, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 233 AZ Primary

Addresses

Primary practice location

5026 W Cactus Rd
Suite 4
Glendale, AZ 85304-2241

Mailing address

220 N McKemy Ave
Chandler, AZ 85226-2654
Phone (480) 961-1865

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
I20040421001317 AZ Practitioner - Optometry 7719973262 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: dr.joseph.taddonio@direct.eyecare-partners.com

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": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1417946989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N MCKEMY AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262654",
            "telephone_number": "480-961-1865",
            "fax_number": "480-961-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5026 W CACTUS RD",
            "address_2": "SUITE 4",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853042241",
            "telephone_number": "602-547-9124",
            "fax_number": "602-547-9634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADDONIO",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.