Individual provider Active NPI

Ardalan Rashidi, OD

  • Optometrist
  • Mesa, AZ
National Provider Identifier
1720742976
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT-002544 Issued in AZ
Practice address
2826 E Baseline Rd Ste 101
Mesa, AZ 85204-7282
Phone
(480) 626-8925
Fax
(480) 704-4036
NPI assigned
Oct 25, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-002544 AZ Primary

Addresses

Primary practice location

2826 E Baseline Rd Ste 101
Mesa, AZ 85204-7282

Mailing address

2826 E Baseline Rd Ste 101
Mesa, AZ 85204-7282
Phone (480) 626-8925

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
I20230201000860 AZ Practitioner - Optometry 3173994035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyes on Site PLLCGroup PAC ID 3779659263, 4 clinicians

Practice addresses (Care Compare)

2826 E Baseline Rd
Suite 101
Mesa, AZ 85204-7282
Phone (480) 626-8925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eyes on Site PLLC Optometrist CurrentSince Jun 24, 2023 Accepting new patients
Eyes on Site PLLC Optometrist CurrentSince Jun 24, 2023 Accepting new patients

Locations

2826 E Baseline Rd
Ste 101
Mesa, AZ 85204
Phone (480) 626-8925

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1720742976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2826 E BASELINE RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047282",
            "telephone_number": "480-626-8925",
            "fax_number": "480-704-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2826 E BASELINE RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047282",
            "telephone_number": "480-626-8925",
            "fax_number": "480-704-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASHIDI",
        "first_name": "ARDALAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-25",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.