Active NPI
Northern Arizona Eye Associates
- Ambulatory Surgical Clinic/Center
- Flagstaff, AZ
National Provider Identifier
1679539688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- NORTHERN ARIZONA EYE ASSOCIATES
- Practice address
- 900 N San Francisco St
Flagstaff, AZ 86001-3236 - Phone
- (928) 779-7000
- NPI assigned
- Apr 26, 2006
- Last updated
- Apr 25, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert Mahanti, M.D.
- Title
- President
- Phone
- (928) 779-7000
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
900 N San Francisco St
Flagstaff, AZ 86001-3236
Mailing address
PO Box 31012
Flagstaff, AZ 86003-1012
Phone (928) 779-7000
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4533000 | Other | CIGNA | |
| 383589 | Other | AZ | APIPA |
| 1Z0155 | Other | HEALTH NET | |
| 383589 | Medicaid | AZ | |
| 490003130 | Other | AZ | MEDICARE RAILROAD |
| AZ0204940 | Other | AZ | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070815000592 | AZ | Part B Supplier - Ambulatory Surgical Center | 5991748212 | Practice locations: Flagstaff, AZ |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Northern Arizona Eye Associates
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Northern Arizona Eye Associates
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ophthalmology Physician
- Flagstaff, AZ
- NPI 1659445062
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Ophthalmology Physician
- Flagstaff, AZ
- NPI 1730146499
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1209081600000",
"number": "1679539688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31012",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860031012",
"telephone_number": "928-779-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 N SAN FRANCISCO ST",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013236",
"telephone_number": "928-779-7000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHERN ARIZONA EYE ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-26",
"last_updated": "2008-04-25",
"status": "A",
"authorized_official_last_name": "MAHANTI",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "928-779-7000",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "4533000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APIPA",
"identifier": "383589",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "1Z0155",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "383589",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "490003130",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "AZ0204940",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
- Northern Arizona Cardiovascular Specialists PC
- Northern Arizona Dermatology Center PC
- Northern Arizona Dermatology Center PC
- Northern Arizona Ear Nose and Throat PC
- Northern Arizona Eye Associates
- Northern Arizona Gastroenterology
- Northern Arizona Healthcare Corporation (Northern Arizona Healthcare Medical Group Entire Care)
- Northern Arizona Healthcare Corporation (Northern Arizona Healthcare Medical Group Specialty Clinic)
- Northern Arizona Healthcare Corporation (NAH Health Center- Central Flagstaff)
- Northern Arizona Healthcare Corporation (NAH Health Center - Central Flagstaff Specialty Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.