Phoenix Oculoplastic Consultants, PLLC

Primary specialty

Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X

License

33016 Issued in AZ

Legal business name

PHOENIX OCULOPLASTIC CONSULTANTS, PLLC

Practice address

3410 N 4TH Ave
Phoenix, AZ 85013-3905

Phone

(602) 257-1499

Fax

(480) 361-3517

NPI assigned

Nov 8, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Misha Faustina, M.D.

Title

Manager

Phone

(602) 257-1498

Specialties & licenses 2

Addresses

Other identifiers 4

Locations

Practitioners 1

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

• Misha-Michelle M Faustina, MD

  • Ophthalmology Physician
  • Worcester, MA
  • NPI 1669438057
  NPD (past)

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352332800000",
    "number": "1497009641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 E INDIAN SCHOOL RD",
            "address_2": "SUITE 21-440",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185360",
            "telephone_number": "602-257-1498",
            "fax_number": "480-361-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 N 4TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133905",
            "telephone_number": "602-257-1499",
            "fax_number": "480-361-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX OCULOPLASTIC CONSULTANTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-08",
        "last_updated": "2012-11-08",
        "status": "A",
        "authorized_official_last_name": "FAUSTINA",
        "authorized_official_first_name": "MISHA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-257-1498",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "33016",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "AZ",
            "license": "33016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1952570194",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "868672",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1669438057",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "608730",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phoenix Neurology and Sleep Medicine PLLC
• Phoenix Oasis Recovery Homes Inc.
• Phoenix Oasis Recovery Homes Inc.
• Phoenix Oasis Recovery Homes Inc.
• Phoenix Obstetrics & Gynecology
• Phoenix Operations, LLC
• Phoenix Ophthalmologists PA
• Phoenix Ophthalmology ASC LLC
• Phoenix Oral and Maxillofacial Surgeons
• Phoenix Oral Surgery Associates PLLC

• Plastic Surgery Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Plastic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.