John Schrolucke, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

AZ0212 Issued in AZ

Practice address

5140 W Peoria Ave
Ste. 116
Glendale, AZ 85302-1630

Phone

(623) 487-1100

Fax

(623) 487-1417

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dr. John Schrolucke, Optometrist

  • Optometrist
  • Glendale, AZ
  • NPI 1912112756
  NPD (past) Authorized official
• Dr. John Schrolucke, Optometrist

  • Optometrist
  • Wickenburg, AZ
  • NPI 1386851814
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1659460848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 W PEORIA AVE",
            "address_2": "STE. 116",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853021630",
            "telephone_number": "623-487-1100",
            "fax_number": "623-487-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 W PEORIA AVE",
            "address_2": "STE. 116",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853021630",
            "telephone_number": "623-487-1100",
            "fax_number": "623-487-1417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROLUCKE",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "AZ0212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.