Active NPI
Joseph Taddonio, O.D.
- Optometrist
- Glendale, AZ
National Provider Identifier
1417946989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 233
- 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, 2014
- 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 | 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- 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": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.