Arizona Ophthalmology Specialists, PLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

ARIZONA OPHTHALMOLOGY SPECIALISTS, PLC

Practice address

4824 E Baseline Rd
Suite 110
Mesa, AZ 85206-4676

Phone

(480) 615-2020

Fax

(480) 219-9957

NPI assigned

Jul 20, 2006

Organization subpart

No

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

Authorized official

Name

Lee Sa B Jackson, MDNPI 1306837042

Title

Physician

Phone

(480) 615-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lee Sa B. Jackson, M.D.

  • Ophthalmology Physician
  • Mesa, AZ
  • NPI 1306837042
  Medicare reassignment NPD Authorized official
• Hussam Seif Eddeine, MD

  • Neurology Physician
  • Chandler, AZ
  • NPI 1306000179
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482883200000",
    "number": "1427078906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD",
            "address_2": "SUITE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064676",
            "telephone_number": "480-615-2020",
            "fax_number": "480-219-9957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 E BASELINE RD",
            "address_2": "SUITE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064676",
            "telephone_number": "480-615-2020",
            "fax_number": "480-219-9957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA OPHTHALMOLOGY SPECIALISTS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-12-28",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "LEE SA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "480-615-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "62874",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arizona Nevada Visiting Nurses
• Arizona Non-Medical Transportation
• Arizona Occupational Medical Clinics
• Arizona Oculofacial Plastic Orbit and Cosmetic Surgery, LLC
• Arizona on Call Health
• Arizona Orthopedic & Sports Medicine Associates Inc
• Arizona Pain and Spine Institute PLLC
• Arizona Pain Management Specialists
• Arizona Pain Treatment Center P C
• Arizona Pediatric Eye Specialists, PLC

• Ophthalmology Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Ophthalmology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.