Organization Active NPI

Jennifer Valente Caywood OD LTD

  • Health Service Clinic/Center
  • Tucson, AZ
National Provider Identifier
1881219491
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
JENNIFER VALENTE CAYWOOD OD LTD
Practice address
2312 N Rosemont Blvd Ste 103
Tucson, AZ 85712-6114
Phone
(520) 261-2563
Fax
(520) 263-1269
NPI assigned
Jun 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Authorized official

Name
Jennifer Valente Caywood, ODNPI 1649267055
Title
Optometrist
Phone
(520) 820-8176

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
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

2312 N Rosemont Blvd Ste 103
Tucson, AZ 85712-6114

Mailing address

10269 E Gray Hawk Dr
Tucson, AZ 85730-6115
Phone (520) 820-8176

Other practice location 1

4340 W Ina Rd
Tucson, AZ 85741-2232
Phone (520) 261-2563

Other identifiers 1

IdentifierTypeStateIssuer
965808MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200609002514 AZ Part B Supplier - Clinic/Group Practice 8123449600 Receives reassigned benefits from 1 practitioner
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory

Locations

3615 N Prince Village Pl
Ste 101
Tucson, AZ 85719

7402 E Broadway Blvd
Tucson, AZ 85710
Phone (520) 261-2563

1607 N Wilmot Rd
Ste 101D
Tucson, AZ 85712
Phone (520) 261-2563

Practitioners & affiliated clinicians

Practitioners 2

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": "1591660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1881219491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10269 E GRAY HAWK DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857306115",
            "telephone_number": "520-820-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 N ROSEMONT BLVD STE 103",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857126114",
            "telephone_number": "520-261-2563",
            "fax_number": "520-263-1269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4340 W Ina Rd",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857412232",
            "country_code": "US",
            "telephone_number": "520-261-2563",
            "fax_number": "520-263-1269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JENNIFER VALENTE CAYWOOD OD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "VALENTE CAYWOOD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "520-820-8176",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "965808",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.