Individual provider Active NPI

Ghadeer A Makoshi, O.D.,F.A.A.O

  • Pediatric Optometrist
  • Chandler, AZ
National Provider Identifier
1902052855
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
1681 Issued in AZ
Practice address
220 N McKemy Ave
Chandler, AZ 85226-2654
Phone
(480) 961-1865
NPI assigned
Aug 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X 1681 AZ Primary
Pediatric Optometrist 152WP0200X 2008023450 MO

Addresses

Primary practice location

220 N McKemy Ave
Chandler, AZ 85226-2654

Mailing address

220 N McKemy Ave
Chandler, AZ 85226-2654
Phone (480) 961-1865

Other identifiers 1

IdentifierTypeStateIssuer
Z144717OtherAZMEDICARE PTAN

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
I20110407000748 AZ Practitioner - Optometry 3971787409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Children'S HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2008023450MOMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Jan 1, 2023 Accepting new patients
Phoenix Children'S Hospital CurrentSince Jan 1, 2023 Accepting new patients
Children'S Brain Academy PastSince May 7, 2023 Accepting new patients
Abc Children'S Eye Specialists PC Past Accepting new patients

Locations

3370 S Mercy Rd
Gilbert, AZ 85297
Phone (602) 933-0935

3370 S Mercy Rd
Ste 213
Gilbert, AZ 85297

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

1920 E Cambridge Ave
Ste 203
Phoenix, AZ 85006
Phone (602) 933-3937

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

20201 N Scottsdale Healthcare Dr
Ste 150
Scottsdale, AZ 85255
Phone (480) 433-7185

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1902052855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N MCKEMY AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262654",
            "telephone_number": "480-961-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N MCKEMY AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262654",
            "telephone_number": "480-961-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKOSHI",
        "first_name": "GHADEER",
        "middle_name": "A",
        "credential": "O.D.,F.A.A.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "AZ",
            "license": "1681",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MO",
            "license": "2008023450",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z144717",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.