NPIMap

Organization Active NPI

Southwestern Eye Center, LTD

  • Durable Medical Equipment & Medical Supplies
  • Prescott, AZ
National Provider Identifier
1609344209
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SOUTHWESTERN EYE CENTER, LTD
Doing business as
SOUTHWESTERN EYE CENTER - PRESCOTT OPTICAL
Practice address
3192 Willow Creek Rd
Prescott, AZ 86301-6610
Phone
(928) 445-1234
Fax
(928) 771-8107
NPI assigned
Nov 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Authorized official

Name
Arthur D Brookfield
Title
Chief Financial Officer
Phone
(602) 598-7488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

3192 Willow Creek Rd
Prescott, AZ 86301-6610

Mailing address

63 S Rockford Dr Ste 220
Tempe, AZ 85288-6226
Phone (602) 598-7488

Other names 1

  • SOUTHWESTERN EYE CENTER - PRESCOTT OPTICAL Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190116001213 AZ DME Supplier - Physician - Optometrist 1850296989 Practice locations: Prescott, AZ

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 23

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2159349Southwestern Eye Center, LTD Dba3192 Willow Creek Road, Prescott, AZ 86301Certificate of waiverDec 17, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Southwestern Eye Center3192 Willow Creek Rd, Prescott, AZ 86301-6610(928) 771-1234 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Dec 19, 2011

National Provider Directory

National Provider Directory
Tax ID family
Southwestern Eye Center18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3192 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 445-1234

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1609344209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 S ROCKFORD DR STE 220",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852886226",
            "telephone_number": "602-598-7488",
            "fax_number": "602-231-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3192 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863016610",
            "telephone_number": "928-445-1234",
            "fax_number": "928-771-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN EYE CENTER, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-13",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "BROOKFIELD",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "602-598-7488"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHWESTERN EYE CENTER - PRESCOTT OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SOUTHWESTERN EYE CENTER - PRESCOTT OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.