Stephen D Phillips, OD
Individual provider Active NPI Optometrist · Sierra Vista, AZ
NPI 1922090984 · NPPES record last updated Aug 26, 2011
Key facts
- NPI
- 1922090984
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1061 (AZ)
- Practice address
- 960 E Fry Blvd
Sierra Vista, AZ 85635-2640 - Phone
- (520) 515-3937
- Fax
- (520) 515-3860
- NPI assigned
- Aug 16, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
960 E Fry Blvd
Sierra Vista, AZ 85635-2640
Phone (520) 515-3937
Merit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081120000089 | AZ | Practitioner - Optometry | 3476613415 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1061 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eyeflyaz, Inc | Optometrist | Current |
Accepting new patients |
Locations
960 E Fry Blvd
Sierra Vista, AZ 85635
Phone (520) 515-3937
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1061 | AZ | Yes |
Addresses
Primary practice location
960 E Fry Blvd
Sierra Vista, AZ 85635-2640
Mailing address
960 E Fry Blvd
Sierra Vista, AZ 85635-2640
Phone (520) 515-3937
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500802002 | Medicaid | AZ |
Other providers in Sierra Vista, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.