Individual provider Active NPI

Heather R Betsko, O.D.

  • Optometrist
  • Mesa, AZ
National Provider Identifier
1841287364
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1386 Issued in AZ
Practice address
777 W Southern Ave
Suite 515
Mesa, AZ 85210-5008
Phone
(480) 461-3937
Fax
(480) 461-0331
NPI assigned
Sep 29, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1386 AZ Primary

Addresses

Primary practice location

777 W Southern Ave
Suite 515
Mesa, AZ 85210-5008

Mailing address

745 W Baseline Rd Ste 21
Mesa, AZ 85210-6023
Phone (480) 461-3937

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
I20041112000579 AZ Practitioner - Optometry 9931163615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

745 W Baseline Rd
Suite 21
Mesa, AZ 85210-6023
Phone (480) 461-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1386AZMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Heather Betsko, LLC Optometrist CurrentSince Feb 13, 2006 Accepting new patients

Locations

1040 S Gilbert Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 893-8776

777 W Southern Ave
Ste 515
Mesa, AZ 85210
Phone (480) 461-0331

745 W Baseline Rd
Ste 21
Mesa, AZ 85210
Phone (480) 461-3937

Interoperability endpoints

  • Direct secure messaging: direct@acuityeyecentermesaaz.compulinkdirect.com

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1841287364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 W BASELINE RD STE 21",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106023",
            "telephone_number": "480-461-3937",
            "fax_number": "480-461-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 W SOUTHERN AVE",
            "address_2": "SUITE 515",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105008",
            "telephone_number": "480-461-3937",
            "fax_number": "480-461-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETSKO",
        "first_name": "HEATHER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.