Individual provider Active NPI

Kay Chan Powell

  • Optometrist
  • Tempe, AZ
National Provider Identifier
1770938441
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2171 Issued in AZ
Practice address
1720 E Warner Rd Ste 9
Tempe, AZ 85284-4542
Phone
(480) 758-4804
Fax
(480) 940-1832
NPI assigned
Apr 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2171 AZ Primary

Addresses

Primary practice location

1720 E Warner Rd Ste 9
Tempe, AZ 85284-4542

Mailing address

1424 S Silverado St
Gilbert, AZ 85296-4179
Phone (608) 516-9285

Other practice location 1

3570 S Val Vista Dr Ste R-105
Gilbert, AZ 85297-7326
Phone (480) 899-2381

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
I20170614001729 AZ Practitioner - Optometry 1153613013 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amanda Misinco, PLLCGroup PAC ID 4688858848, 2 clinicians

Practice addresses (Care Compare)

1720 E Warner Rd
Suite 9
Tempe, AZ 85284-4542
Phone (480) 785-4804

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2171AZMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda Misinco, PLLC CurrentSince Nov 21, 2024 Accepting new patients
MVP.Vision Optometrist CurrentSince Dec 29, 2019 Accepting new patients
Eye Care Clinic P.C. Optometrist CurrentSince Jul 1, 2017 Accepting new patients
Accurate Family Vision, PLLC Optometrist CurrentSince Oct 18, 2024 Accepting new patients
Carlos L Grandela O.D. PLC CurrentSince Jan 20, 2018 Accepting new patients

Locations

1780 E Boston St
Ste 101
Gilbert, AZ 85295
Phone (480) 813-7050

3570 S Val Vista Dr
Ste R105
Gilbert, AZ 85297
Phone (480) 899-2381

3570 S Val Vista Dr
Ste 105
Gilbert, AZ 85297
Phone (480) 899-2381

3570 S Val Vista Dr
#R105
Gilbert, AZ 85297

1830 S Alma School Rd
Ste 131
Mesa, AZ 85210
Phone (480) 695-2595

10001 W Bell Rd
Ste 115
Sun City, AZ 85351
Phone (623) 583-2800

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

Organizations & group practices 5

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": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1770938441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 S SILVERADO ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964179",
            "telephone_number": "608-516-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 E WARNER RD STE 9",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852844542",
            "telephone_number": "480-758-4804",
            "fax_number": "480-940-1832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3570 S Val Vista Dr Ste R-105",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852977326",
            "country_code": "US",
            "telephone_number": "480-899-2381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "KAY",
        "middle_name": "CHAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.