Tyler Justin Stathis, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

002431 Issued in AZ

Practice address

15681 N Hayden Rd Ste 115
Scottsdale, AZ 85260-1959

Phone

(480) 948-1131

NPI assigned

Jun 22, 2020

Last updated

Sep 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Group practices

Valley Eye Care Inc.Group PAC ID 1355442807, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Valley Eye Care Inc.

  dba Valley Eyecare Center

  • Optometrist
  • Phoenix, AZ
  • NPI 1780797613
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1457977928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8612 E SAN FELIPE DR",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852582550",
            "telephone_number": "480-329-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15681 N HAYDEN RD STE 115",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852601959",
            "telephone_number": "480-948-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATHIS",
        "first_name": "TYLER",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-22",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "002431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Start Fresh Recovery Southwest
• Denise M Stassen, PA-C
• Statclinix PLC (Statclinix - Northsight)
• State 48 Home Health of Phoenix LLC
• State 48 Hospice of Phoenix LLC
• Michael Craig Staub, D.C.
• Stay Dripped IV LLC (Stay Dripped IV)
• Steadfast Integrative Medicine
• Ashton Steadman
• Danielle Alena Stearns, D.O.

• Optometrist in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.