Professional Optometric Services, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1848 Issued in AZ

Legal business name

PROFESSIONAL OPTOMETRIC SERVICES, PC

Practice address

3501 E Broadway Blvd
Optical Dept
Tucson, AZ 85716-5405

Phone

(520) 241-9522

Fax

(520) 881-7248

NPI assigned

Apr 16, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Howard J Rosner, OD

Title

Optometrist

Phone

(248) 939-1213

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1760749659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19190 S ALPHA AVE",
            "address_2": "APT. 9205",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856144846",
            "telephone_number": "248-939-1213",
            "fax_number": "856-219-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 E BROADWAY BLVD",
            "address_2": "OPTICAL DEPT",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857165405",
            "telephone_number": "520-241-9522",
            "fax_number": "520-881-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OPTOMETRIC SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-16",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "ROSNER",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "248-939-1213",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1285719237",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691957",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "MI2468",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Tucson, AZ
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.