NPIMap

Organization Active NPI

Phoenix Eye Institute PLLC

  • Ophthalmology Physician
  • Peoria, AZ
National Provider Identifier
1538440367
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
36025 Issued in AZ
Legal business name
PHOENIX EYE INSTITUTE PLLC
Practice address
14155 N 83Rd Ave
Suite 104
Peoria, AZ 85381-5639
Phone
(623) 773-3937
Fax
(623) 773-3955
NPI assigned
Sep 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Authorized official

Name
Dr. Min Cheol Kim, MD, PHD
Title
President
Phone
(623) 773-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 36025 AZ Primary

Addresses

Primary practice location

14155 N 83Rd Ave
Suite 104
Peoria, AZ 85381-5639

Mailing address

PO Box 5609
Peoria, AZ 85385-5609
Phone (623) 773-3937

National Provider Directory

National Provider Directory

Locations

14155 N 83rd Ave
Ste 103
Peoria, AZ 85381
Phone (623) 773-3937

Practitioners & affiliated clinicians

Practitioners 4

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": "1315353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1538440367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5609",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853855609",
            "telephone_number": "623-773-3937",
            "fax_number": "623-773-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14155 N 83RD AVE",
            "address_2": "SUITE 104",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815639",
            "telephone_number": "623-773-3937",
            "fax_number": "623-773-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX EYE INSTITUTE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-07",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MIN",
        "authorized_official_middle_name": "CHEOL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-773-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "36025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.