Individual provider Active NPI

Benjamin Usleman, O.D.

  • Optometrist
  • Mesa, AZ
National Provider Identifier
1790975647
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1579 Issued in AZ
Practice address
6555 E Southern Ave
#2410
Mesa, AZ 85206-3718
Phone
(480) 854-3468
Fax
(480) 985-7346
NPI assigned
Jul 26, 2007
Last updated
Jul 26, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1579 AZ Primary

Addresses

Primary practice location

6555 E Southern Ave
#2410
Mesa, AZ 85206-3718

Mailing address

11103 West Ave
Ste 6
San Antonio, TX 78213-1370
Phone (210) 524-6803

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
I20070925000186 AZ Practitioner - Optometry 8527152321 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Phoenix Eye Care, PLLC Optometrist CurrentSince Jun 25, 2013 Accepting new patients
2020 Image Chandler Optometrist CurrentSince Aug 9, 2021 Accepting new patients
Phoenix Ophthalmologists PA CurrentSince Mar 18, 2019 Accepting new patients
John H McDougall OD Arizona PC Optometrist CurrentSince Aug 9, 2021 Accepting new patients
Tom Sowash OD & Associates PC Optometrist Past Accepting new patients
Visionworks Inc Past Accepting new patients

Locations

3900 W Ray Rd
Ste 1
Chandler, AZ 85226
Phone (480) 820-9880

13125 N La Montana Dr
Ste 1
Fountain Hls, AZ 85268
Phone (480) 816-0102

1130 E Missouri Ave
Ste 100
Phoenix, AZ 85014
Phone (602) 995-1166

4745 N 7th St
Ste 145
Phoenix, AZ 85014
Phone (602) 265-8597

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1790975647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "STE 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6803",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 E SOUTHERN AVE",
            "address_2": "#2410",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063718",
            "telephone_number": "480-854-3468",
            "fax_number": "480-985-7346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "USLEMAN",
        "first_name": "BENJAMIN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.