Benjamin D Cooper, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1795 Issued in AZ

Practice address

223 Seneca LN
San Carlos, AZ 85550

Phone

(928) 475-7244

Fax

(928) 475-7370

NPI assigned

Jan 8, 2007

Last updated

Nov 12, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mr. Ben D Cooper Other name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Optometry

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Carlos Apache Healthcare CorporationGroup PAC ID 0648580597, 147 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Carlos Apache Healthcare Corporation Hospital, Peridot, AZ, CCN 031320

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075

  TX

  Medicare reassignment Care Compare group NPD
• San Carlos Apache Healthcare Corporation

  dba Clarence Wesley Health Center

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075
  Care Compare affiliation
• San Carlos Apache Healthcare Corporation

  dba Clarence Wesley Health Center

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1609924273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208",
            "city": "SAN CARLOS",
            "state": "AZ",
            "postal_code": "855500208",
            "telephone_number": "928-475-7244",
            "fax_number": "928-475-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 SENECA LN",
            "city": "SAN CARLOS",
            "state": "AZ",
            "postal_code": "85550",
            "telephone_number": "928-475-7244",
            "fax_number": "928-475-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "BENJAMIN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1795",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2003002705",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185037",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEN",
            "last_name": "COOPER",
            "middle_name": "D",
            "prefix": "MR.",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Polly Y Browning, LCSW
• Melinda Rose Cain, LMSW
• Wen-Te Ted Chen, D.O.
• Linda C Clark, RN, CDE
• Benjamin Joseph Cloud, PHARM D.
• Theresa A. Covello, D.O.
• Jordan Clark Davis, PHARM D
• Paul Ray Delgado, RPH
• DHHS IHS Phoenix Area (San Carlos Indian Hospital)
• DHHS IHS Phoenix Area (San Carlos Indian Hospital)

• Optometrist in San Carlos, AZ
• Providers in San Carlos, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.

Verify at the official NPI Registry.