Individual provider Active NPI

Cody D Quarnberg, OD

  • Optometrist
  • Scottsdale, AZ
National Provider Identifier
1902977655
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1457 Issued in AZ
Practice address
7245 E Osborn Rd
Suite 4
Scottsdale, AZ 85251-6443
Phone
(480) 994-5012
Fax
(480) 990-7364
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 1457 AZ
Optometrist 152W00000X 1457 AZ Primary

Addresses

Primary practice location

7245 E Osborn Rd
Suite 4
Scottsdale, AZ 85251-6443

Mailing address

7245 E Osborn Rd
Suite 4
Scottsdale, AZ 85251-6443
Phone (480) 994-5012

Other identifiers 1

IdentifierTypeStateIssuer
230187MedicaidAZ

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
I20051117000172 AZ Practitioner - Optometry 1557380789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Ophthalmologists LTDGroup PAC ID 8325024805, 17 clinicians

Practice addresses (Care Compare)

7245 E Osborn Rd
Suite 4
Scottsdale, AZ 85251-6443
Phone (602) 991-5012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1457AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Ophthalmologists LTD Ophthalmology CurrentSince Jul 28, 2008 Accepting new patients
Associated Ophthalmologist, LTD Optometrist Past Accepting new patients

Locations

4915 E Baseline Rd
Ste 114
Gilbert, AZ 85234
Phone (480) 830-0012

2855 E Brown Rd
Ste 10
Mesa, AZ 85213
Phone (480) 969-1000

300 E Osborn Rd
Ste 100
Phoenix, AZ 85012
Phone (602) 200-0770

300 E Osborn Rd
Phoenix, AZ 85012
Phone (520) 234-8494

7373 N Scottsdale Rd
Ste D100
Scottsdale, AZ 85253

7245 E Osborn Rd
Ste 4
Scottsdale, AZ 85251
Phone (480) 994-5012

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1902977655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7245 E OSBORN RD",
            "address_2": "SUITE 4",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516443",
            "telephone_number": "480-994-5012",
            "fax_number": "480-990-7364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7245 E OSBORN RD",
            "address_2": "SUITE 4",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516443",
            "telephone_number": "480-994-5012",
            "fax_number": "480-990-7364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUARNBERG",
        "first_name": "CODY",
        "middle_name": "D",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "1457",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230187",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.