Organization Active NPI

Az Eye Health PLLC

  • Optometrist
  • Scottsdale, AZ
National Provider Identifier
1487837654
Registry record updated Nov 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1049 Issued in AZ
Legal business name
AZ EYE HEALTH PLLC
Practice address
8575 E Princess Dr
#105
Scottsdale, AZ 85255-5483
Phone
(480) 585-0001
Fax
(480) 585-0760
NPI assigned
Dec 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2008

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

Authorized official

Name
Dr. Brett K Gramlich, O.DNPI 1144211590
Title
Optometrist/ Owner
Phone
(480) 585-0001

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 1105 AZ
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 1049 AZ Primary

Addresses

Primary practice location

8575 E Princess Dr
#105
Scottsdale, AZ 85255-5483

Mailing address

8575 E Princess Dr
#105
Scottsdale, AZ 85255-5483
Phone (480) 585-0001

Other identifiers 2

IdentifierTypeStateIssuer
70768MedicaidAZ
63361MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040518001166 AZ Part B Supplier - Clinic/Group Practice 7012908247 Receives reassigned benefits from 2 practitioners
Practice locations: Scottsdale, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2115149Az Eye Health8575 E Princess Dr, Ste 105, Scottsdale, AZ 85255Certificate of waiverJun 28, 2028

National Provider Directory

National Provider Directory

Locations

8575 E Princess Dr
Ste 105
Scottsdale, AZ 85255
Phone (480) 585-0001

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226448000000",
    "number": "1487837654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8575 E PRINCESS DR",
            "address_2": "#105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555483",
            "telephone_number": "480-585-0001",
            "fax_number": "480-585-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 E PRINCESS DR",
            "address_2": "#105",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555483",
            "telephone_number": "480-585-0001",
            "fax_number": "480-585-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ EYE HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2008-11-12",
        "status": "A",
        "authorized_official_last_name": "GRAMLICH",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OPTOMETRIST/ OWNER",
        "authorized_official_telephone_number": "480-585-0001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1105",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70768",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63361",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.