NPIMap

Organization Active NPI

Prime Eye Care PC

  • Optometrist
  • Phoenix, AZ
National Provider Identifier
1447226295
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
542 Issued in AZ
Legal business name
PRIME EYE CARE PC
Practice address
300 W Clarendon Ave
Suite # 150
Phoenix, AZ 85013-3420
Phone
(602) 265-0343
Fax
(602) 265-5171
NPI assigned
Feb 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Bradley J Smith, O.D.NPI 1922000975
Title
President
Phone
(602) 265-5172

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 542 AZ Primary

Addresses

Primary practice location

300 W Clarendon Ave
Suite # 150
Phoenix, AZ 85013-3420

Mailing address

300 W Clarendon Ave
Suite # 150
Phoenix, AZ 85013-3420
Phone (602) 265-0343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414001072 AZ Part B Supplier - Clinic/Group Practice 4789678301 Receives reassigned benefits from 12 practitioners
Practice locations: Mesa, AZ; Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

3940 E University Dr
#5
Mesa, AZ 85205

3940 E University Dr
Ste 5
Mesa, AZ 85205
Phone (480) 832-0030

3960 E University Dr
Ste 103
Mesa, AZ 85205
Phone (480) 832-0030

6343 E Main St
Ste B7
Mesa, AZ 85205
Phone (480) 832-0030

2423 W Dunlap Ave
Ste 180
Phoenix, AZ 85021
Phone (602) 294-4642

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447226295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE",
            "address_2": "SUITE # 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133420",
            "telephone_number": "602-265-0343",
            "fax_number": "602-265-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE",
            "address_2": "SUITE # 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133420",
            "telephone_number": "602-265-0343",
            "fax_number": "602-265-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-265-5172",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.