Individual provider Active NPI

Amy Crump, OD

  • Optometrist
  • Mesa, AZ
National Provider Identifier
1881673150
Registry record updated Mar 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
960 Issued in AZ
Practice address
220 S 63Rd St
Mesa, AZ 85206-1619
Phone
(480) 641-3937
NPI assigned
Jan 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 960 AZ Primary

Addresses

Primary practice location

220 S 63Rd St
Mesa, AZ 85206-1619

Mailing address

220 S 63Rd St
Mesa, AZ 85206-1619
Phone (480) 641-3937

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
I20051013000115 AZ Practitioner - Optometry 6608891122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Valley Ophthalmology LTDGroup PAC ID 7911986989, 7 clinicians

Practice addresses (Care Compare)

5620 E Broadway Rd
Mesa, AZ 85206-1438
Phone (480) 981-6111

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
960AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Swagel-Wootton Eye Center, Inc Current Accepting new patients
East Valley Ophthalmology, LTD CurrentSince May 18, 2020 Accepting new patients

Locations

5620 E Broadway Rd
Mesa, AZ 85206
Phone (480) 981-6111

220 S 63rd St
Mesa, AZ 85206
Phone (480) 641-3937

5540 E Broadway Rd
Ste 8
Mesa, AZ 85206
Phone (480) 830-0702

3900 E Mexico Ave
Ste 102
Denver, CO 80210
Phone (303) 800-2078

Organizations & group practices 2

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1881673150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S 63RD ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061619",
            "telephone_number": "480-641-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S 63RD ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061619",
            "telephone_number": "480-641-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMP",
        "first_name": "AMY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.