Individual provider Active NPI

Renee Christine Hanson, O.D.

  • Optometrist
  • Mesa, AZ
National Provider Identifier
1881719540
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2318 Issued in AZ
Practice address
220 S 63Rd St
Mesa, AZ 85206-1619
Phone
(480) 641-3937
Fax
(480) 924-5094
NPI assigned
Mar 20, 2007
Last updated
Oct 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2318 AZ Primary
Optometrist 152W00000X 12467 TPL CA
Pediatric Optometrist 152WP0200X 12467 TPL CA

Addresses

Primary practice location

220 S 63Rd St
Mesa, AZ 85206-1619

Mailing address

PO Box 200414
Dallas, TX 75320-0414
Phone (480) 641-3937

Other practice location 1

3940 S Alma School Rd Ste 3
Chandler, AZ 85248-4513
Phone (480) 641-3937

Other identifiers 1

IdentifierTypeStateIssuer
12467TPLOtherCASTATE LICENSE

Other names 1

  • Renee Christine Wyckoff Former name

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
I20190516001513 AZ Practitioner - Optometry 6406916758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swagel-Wootton Eye Center, IncGroup PAC ID 9335130046, 10 clinicians

Practice addresses (Care Compare)

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

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12467CAMDProfessional Counselor
2318AZMDOptometrist
12467 TPLCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Swagel-Wootton Eye Center, Inc Optometrist CurrentSince May 1, 2019 Accepting new patients
Swagel-Wootton Eye Center, Inc CurrentSince May 1, 2019 Accepting new patients
Swagel-Wootton Eye Center, Inc Current Accepting new patients
Emergency Medical & Surgical Specialists of Colorado LLC Past Accepting new patients

Locations

3940 S Alma School Rd
Ste 3
Chandler, AZ 85248
Phone (480) 641-3937

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

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

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: renee.hanson.p3@direct.keec.nextgenshare.com

Organizations & group practices 4

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1881719540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200414",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753200414",
            "telephone_number": "480-641-3937",
            "fax_number": "480-924-5094"
        },
        {
            "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",
            "fax_number": "480-924-5094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3940 S Alma School Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852484513",
            "country_code": "US",
            "telephone_number": "480-641-3937",
            "fax_number": "480-924-5094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "RENEE",
        "middle_name": "CHRISTINE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2318",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "12467 TPL",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "CA",
            "license": "12467 TPL",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "12467TPL",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "WYCKOFF",
            "middle_name": "CHRISTINE",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.