Organization Active NPI

Ancala Eye Care P C

  • Optometrist
  • Scottsdale, AZ
National Provider Identifier
1871788133
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD890 Issued in AZ
Legal business name
ANCALA EYE CARE P C
Practice address
11219 E Via Linda
Suite D3
Scottsdale, AZ 85259-4069
Phone
(480) 451-4519
Fax
(480) 451-4858
NPI assigned
Sep 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
Dr. Stuart L Greenberg, O.D.NPI 1710022736
Title
President
Phone
(480) 451-4519

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OD890 AZ Primary

Addresses

Primary practice location

11219 E Via Linda
Suite D3
Scottsdale, AZ 85259-4069

Mailing address

11219 E Via Linda
Suite D3
Scottsdale, AZ 85259-4069
Phone (480) 451-4519

Other identifiers 1

IdentifierTypeStateIssuer
OD890OtherAZMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170216000763 AZ Part B Supplier - Clinic/Group Practice 0345523353 Receives reassigned benefits from 1 practitioner
Practice locations: Scottsdale, AZ

National Provider Directory

National Provider Directory

Locations

11219 E Via Linda
Ste D3
Scottsdale, AZ 85259
Phone (480) 451-4519

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1871788133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11219 E VIA LINDA",
            "address_2": "SUITE D3",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852594069",
            "telephone_number": "480-451-4519",
            "fax_number": "480-451-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11219 E VIA LINDA",
            "address_2": "SUITE D3",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852594069",
            "telephone_number": "480-451-4519",
            "fax_number": "480-451-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANCALA EYE CARE P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-451-4519",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OD890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "OD890",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.