Individual provider Active NPI

Sean Courtney Dennis

  • Optometrist
  • Phoenix, AZ
National Provider Identifier
1568038693
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002525 Issued in AZ
Practice address
2929 E Camelback Rd Ste 110
Phoenix, AZ 85016-4425
Phone
(602) 599-0132
NPI assigned
May 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002525 AZ Primary

Addresses

Primary practice location

2929 E Camelback Rd Ste 110
Phoenix, AZ 85016-4425

Mailing address

32713 N 19TH LN
Phoenix, AZ 85085-7266
Phone (253) 985-0396

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240919001135 AZ Practitioner - Optometry 5496296337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

937 N Dobson Rd
Suite 102
Mesa, AZ 85201-7589
Phone (480) 649-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002525AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Vision Care Arizona PLLC Optometrist CurrentSince Sep 9, 2024 Accepting new patients
Family First Vision Care Arizona PLLC Optometrist CurrentSince Sep 9, 2024 Accepting new patients

Locations

7131 W Ray Rd
Ste 33
Chandler, AZ 85226
Phone (480) 561-5059

2475 S Val Vista Dr
Ste 103
Gilbert, AZ 85295
Phone (480) 739-9445

937 N Dobson Rd
Ste 102
Mesa, AZ 85201
Phone (480) 649-6100

10706 E Point Twenty Two Blvd
Ste 107
Mesa, AZ 85212
Phone (480) 454-1610

316 S Hamilton Rd
Gahanna, OH 43230

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1622332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1568038693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32713 N 19TH LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850857266",
            "telephone_number": "253-985-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 E CAMELBACK RD STE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164425",
            "telephone_number": "602-599-0132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "SEAN",
        "middle_name": "COURTNEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-30",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "002525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.