NPIMap

Organization Active NPI

Dr. Simon Zmyslinski & Associates, P.L.L.C.

  • Optometrist
  • Phoenix, AZ
National Provider Identifier
1710213434
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
AZ1051 Issued in AZ
Legal business name
DR. SIMON ZMYSLINSKI & ASSOCIATES, P.L.L.C.
Practice address
9617 N Metro Pkwy W Ste 1000
Phoenix, AZ 85051-1416
Phone
(602) 678-4395
Fax
(602) 678-4396
NPI assigned
Oct 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Authorized official

Name
Dr. Simon R Zmyslinski, O.D.NPI 1477613024
Title
Owner
Phone
(602) 678-4395

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)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X AZ1051 AZ Primary

Addresses

Primary practice location

9617 N Metro Pkwy W Ste 1000
Phoenix, AZ 85051-1416

Mailing address

9617 N Metro Pkwy W Ste 1000
Phoenix, AZ 85051-1416
Phone (602) 678-4395

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091221000556 AZ Part B Supplier - Clinic/Group Practice 8729128889 Receives reassigned benefits from 9 practitioners
Practice locations: Phoenix, AZ; Tempe, AZ; Scottsdale, AZ

National Provider Directory

National Provider Directory

Locations

9617 N Metro Pkwy W
Ste 1000
Phoenix, AZ 85051
Phone (602) 678-4395

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1710213434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9617 N METRO PKWY W STE 1000",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511416",
            "telephone_number": "602-678-4395",
            "fax_number": "602-678-4396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9617 N METRO PKWY W STE 1000",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511416",
            "telephone_number": "602-678-4395",
            "fax_number": "602-678-4396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SIMON ZMYSLINSKI & ASSOCIATES, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "ZMYSLINSKI",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-678-4395",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "AZ1051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.