NPIMap

Organization Active NPI

Amanda Misinco, PLLC

Doing business as Optical Intuitions

  • Clinic/Center
  • Tempe, AZ
National Provider Identifier
1730478389
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
1686 Issued in AZ
Legal business name
AMANDA MISINCO, PLLC
Doing business as
Optical Intuitions
Practice address
9855 S Priest Dr
Suite 101
Tempe, AZ 85284-3605
Phone
(480) 785-4804
Fax
(480) 940-1832
NPI assigned
Apr 5, 2011
Last updated
Dec 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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

Authorized official

Name
Amanda S Misinco, O.D.NPI 1477781516
Title
Sole Member
Phone
(480) 785-4804

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
Clinic/Center 261Q00000X 1686 AZ Primary

Addresses

Primary practice location

9855 S Priest Dr
Suite 101
Tempe, AZ 85284-3605

Mailing address

2206 N 24TH St
Mesa, AZ 85213-2245
Phone (480) 478-9562

Other names 1

  • Optical Intuitions Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110412000996 AZ Part B Supplier - Clinic/Group Practice 4688858848 Receives reassigned benefits from 2 practitioners
Practice locations: Tempe, AZ

National Provider Directory

National Provider Directory

Locations

1720 E Warner Rd
Ste 9
Tempe, AZ 85284
Phone (480) 758-4804

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354492800000",
    "number": "1730478389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 N 24TH ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852132245",
            "telephone_number": "480-478-9562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9855 S PRIEST DR",
            "address_2": "SUITE 101",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852843605",
            "telephone_number": "480-785-4804",
            "fax_number": "480-940-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA MISINCO, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2012-12-03",
        "status": "A",
        "authorized_official_last_name": "MISINCO",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "480-785-4804",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "1686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optical Intuitions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.