Individual provider Active NPI

Matthew Littlejohn, OD

  • Optometrist
  • Casa Grande, AZ
National Provider Identifier
1780603142
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1525 Issued in AZ
Practice address
1968 N Peart Rd Ste 12
Casa Grande, AZ 85122-2496
Phone
(520) 836-9606
Fax
(520) 836-3964
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1525 AZ Primary

Addresses

Primary practice location

1968 N Peart Rd Ste 12
Casa Grande, AZ 85122-2496

Mailing address

1968 N Peart Rd Ste 12
Casa Grande, AZ 85122-2496
Phone (520) 836-9606

Other identifiers 4

IdentifierTypeStateIssuer
387419MedicaidAZ
D09166OtherRAILROAD MEDICARE
DU5966OtherAZRAILROAD MEDICARE
152W00000XOtherAZTAXONOMY

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
I20061030000606 AZ Practitioner - Optometry 8022015346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

653 E Cottonwood LN
Casa Grande Vision Center
Casa Grande, AZ 85122-2023
Phone (520) 836-9606

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1525AZMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew Littlejohn OD PC Optometrist CurrentSince May 23, 2013 Accepting new patients

Locations

1968 N Peart Rd
Ste 12
Casa Grande, AZ 85122
Phone (520) 836-9606

653 E Cottonwood Ln
Casa Grande, AZ 85122
Phone (520) 836-9606

Organizations & group practices 1

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1780603142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1968 N PEART RD STE 12",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851222496",
            "telephone_number": "520-836-9606",
            "fax_number": "520-836-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 N PEART RD STE 12",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851222496",
            "telephone_number": "520-836-9606",
            "fax_number": "520-836-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLEJOHN",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387419",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "D09166",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DU5966",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "152W00000X",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

Verify at the official NPI Registry.