Individual provider Active NPI

Stephanie M Mastores, O.D.

  • Optometrist
  • Phoenix, AZ
National Provider Identifier
1619107588
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-001704 Issued in AZ
Practice address
6040 N 7TH Street Suite 300
Phoenix, AZ 85014
Phone
(602) 825-3937
NPI assigned
Jul 24, 2009
Last updated
Dec 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X AZ1704 AZ
Optometrist 152W00000X OPT-001704 AZ Primary

Addresses

Primary practice location

6040 N 7TH Street Suite 300
Phoenix, AZ 85014

Mailing address

6040 N 7TH St Ste 300
Phoenix, AZ 85014-1848
Phone (614) 915-7174

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
I20090914000117 AZ Practitioner - Optometry 9638225857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Ophthalmologists PAGroup PAC ID 2769469154, 3 clinicians

Practice addresses (Care Compare)

1130 E Missouri Ave
Phoenix, AZ 85014-2712
Phone (602) 995-1166

6040 N 7TH St
Suite 300
Phoenix, AZ 85014-1848
Phone (602) 825-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AZ1704AZMDOptometrist
OPT-001704AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Ophthalmologists PA CurrentSince Apr 21, 2025 Accepting new patients
Blink Eye Care Phoenix Optometrist CurrentSince Oct 1, 2021 Accepting new patients
Family Eyecare of Scottsdale, PLC Optometrist PastSince Jul 1, 2009 Accepting new patients
Family Eyecare Associates of Az PLC Optometrist Past Accepting new patients

Locations

1130 E Missouri Ave
Ste 100
Phoenix, AZ 85014
Phone (602) 995-1166

6040 N 7th St
Ste 300
Phoenix, AZ 85014
Phone (602) 825-3937

7000 N 16th St
Ste 120
Phoenix, AZ 85020
Phone (602) 395-1818

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1619107588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 N 7TH ST STE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850141848",
            "telephone_number": "614-915-7174",
            "fax_number": "602-855-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 N 7TH STREET SUITE 300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85014",
            "telephone_number": "602-825-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTORES",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "AZ1704",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-001704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.