Active NPI
Nationwide Optometry P.C.
- Optometrist
- Buckeye, AZ
National Provider Identifier
1518154756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- NATIONWIDE OPTOMETRY P.C.
- Doing business as
- Nationwide Vision
- Practice address
- 860 S Watson Rd Ste 107
Buckeye, AZ 85326-3432 - Phone
- (623) 386-8802
- Fax
- (623) 327-1669
- NPI assigned
- Oct 2, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jarrod Cross, OD
- Title
- President
- Phone
- (509) 201-0051
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
860 S Watson Rd Ste 107
Buckeye, AZ 85326-3432
Mailing address
955 W Southern Ave Ste 101
Mesa, AZ 85210-4903
Phone (480) 961-1865
Other names 1
- Nationwide Vision
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131217000251 | AZ | Part B Supplier - Clinic/Group Practice | 6901033075 |
Receives reassigned benefits from 131 practitioners This NPI is an additional NPI on the enrollment |
| O20241211002749 | AZ | DME Supplier - Physician - Optometrist | 6901033075 | Practice locations: Buckeye, AZ |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191283200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1731542400000",
"number": "1518154756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "955 W SOUTHERN AVE STE 101",
"city": "MESA",
"state": "AZ",
"postal_code": "852104903",
"telephone_number": "480-961-1865",
"fax_number": "480-893-8172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 S WATSON RD STE 107",
"city": "BUCKEYE",
"state": "AZ",
"postal_code": "853263432",
"telephone_number": "623-386-8802",
"fax_number": "623-327-1669"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NATIONWIDE OPTOMETRY P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-02",
"last_updated": "2024-11-14",
"certification_date": "2024-11-14",
"status": "A",
"authorized_official_last_name": "CROSS",
"authorized_official_first_name": "JARROD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "509-201-0051",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Nationwide Vision",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Buckeye, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.