Active NPI
Kevin Pugh, OD
- Optometrist
- Mesa, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2054
- Practice address
- 1055 S Stapley Dr
Mesa, AZ 85204 - Phone
- (480) 833-9100
- Fax
- (480) 833-6000
- NPI assigned
- Jul 1, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2054 | AZ | Primary |
Addresses
Primary practice location
1055 S Stapley Dr
Mesa, AZ 85204
Mailing address
4800 N 22ND St Ste 210
Phoenix, AZ 85016-4963
Phone (480) 892-8400
Other practice location 1
1055 S Stapley Dr
Mesa, AZ 85204-5098
Phone (480) 833-9100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 032451 | Medicaid | AZ |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4760 E Falcon Dr
Suite 101
Mesa, AZ 85215-2528
Phone (480) 985-7400
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.66 of 100
- Quality
- 84.9
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.31
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2054 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwestern Eye Center LTD | Current | Accepting new patients | |
| Southwestern Eye Center, LTD | Optometrist | Current | Accepting new patients |
| Southwestern Eye Center, LTD | Optometrist | Current | Accepting new patients |
| Barnet Dulaney Perkins Eye Center, PC | Current | Accepting new patients | |
| Barnet Dulaney Perkins Eye Center, PC | Current | Accepting new patients | |
| Barnet Dulaney Perkins Eye Center, PC | Current | Accepting new patients | |
| Eye Guys | Optometrist | Past | Accepting new patients |
Locations
41810 N Venture Dr
Ste E152
Anthem, AZ 85086
Phone (623) 584-9295
3003 Highway 95
Ste 63
Bullhead City, AZ 86442
Phone (928) 763-7555
270 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-4202
5285 W Bell Rd
Ste 110
Glendale, AZ 85308
Phone (602) 903-0922
1055 S Stapley Dr
Mesa, AZ 85204
Phone (480) 833-9100
5250 E Southern Ave
Mesa, AZ 85206
Phone (480) 420-1005
1121 S Gilbert Rd
Ste 103
Mesa, AZ 85204
Phone (480) 459-8500
7435 E Main St
Ste 101
Mesa, AZ 85207
Phone (480) 634-3777
4760 E Falcon Dr
Ste 101
Mesa, AZ 85215
Phone (480) 985-7400
6705 E McDowell Rd
Mesa, AZ 85215
Phone (480) 985-7400
4800 N 22nd St
Ste 210
Phoenix, AZ 85016
Phone (602) 598-7488
4800 N 22nd St
Ste 120
Phoenix, AZ 85016
4800 N 22nd St
Phoenix, AZ 85016
Phone (602) 508-4843
13215 N 7th St
Phoenix, AZ 85022
2370 W State Route 89A
Ste 16A17A18
Sedona, AZ 86336
Phone (928) 282-1231
13624 W Camino del Sol
Ste 200
Sun City West, AZ 85375
Phone (623) 546-6599
698 E Wetmore Rd
Ste 100
Tucson, AZ 85705
Phone (520) 690-5707
5632 E 5th St
Tucson, AZ 85711
Phone (520) 584-8888
2149 W 24th St
Yuma, AZ 85364
Phone (928) 726-1100
Interoperability endpoints
- kevin.pugh@direct.avp.nextgenshare.com
- kevin.pugh.p11@direct.avp.nextgenshare.com
Organizations & group practices 7
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.
-
- Ophthalmology Physician
- Scottsdale, AZ
- NPI 1023063187
-
- Ophthalmology Physician
- Phoenix, AZ
- NPI 1376574707
-
- Ambulatory Surgical Clinic/Center
- Mesa, AZ
- NPI 1043910078
-
- Ophthalmology Physician
- Flagstaff, AZ
- NPI 1689619272
-
- Durable Medical Equipment & Medical Supplies
- Tempe, AZ
- NPI 1558102608
Optometrist
-
- Optometrist
- Wasilla, AK
- NPI 1053646570
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708646400000",
"number": "1568845097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4800 N 22ND ST STE 210",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850164963",
"telephone_number": "480-892-8400",
"fax_number": "602-508-4830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 S STAPLEY DR",
"city": "MESA",
"state": "AZ",
"postal_code": "85204",
"telephone_number": "480-833-9100",
"fax_number": "480-833-6000"
}
],
"practiceLocations": [
{
"address_1": "1055 S Stapley Dr",
"address_purpose": "LOCATION",
"city": "Mesa",
"state": "AZ",
"postal_code": "852045098",
"country_code": "US",
"telephone_number": "480-833-9100",
"fax_number": "602-508-4830",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PUGH",
"first_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-01",
"last_updated": "2024-02-23",
"certification_date": "2021-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "2054",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "032451",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.