Individual provider Active NPI

Richard Wood, O.D.

  • Optometrist
  • Gilbert, AZ
National Provider Identifier
1972591105
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1148 Issued in AZ
Practice address
1496 N Higley Rd
Suite 104
Gilbert, AZ 85234-1601
Phone
(480) 279-4400
Fax
(480) 981-0548
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1148 AZ Primary

Addresses

Primary practice location

1496 N Higley Rd
Suite 104
Gilbert, AZ 85234-1601

Mailing address

1378 E Boston St
Gilbert, AZ 85296-6141
Phone (480) 570-5318

Other identifiers 1

IdentifierTypeStateIssuer
079582MedicaidAZ

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
I20040108001034 AZ Practitioner - Optometry 5193625002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard E Wood OD and Associates LLCGroup PAC ID 9234139320, 2 clinicians

Practice addresses (Care Compare)

4915 E Baseline Rd
Gilbert, AZ 85234-2966
Phone (480) 279-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1148AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard E Wood OD and Associates LLC Optometrist CurrentSince May 21, 2009 Accepting new patients
Gilbert Family Eyecare Optometrist Past Accepting new patients

Locations

1496 N Higley Rd
Ste 104
Gilbert, AZ 85234
Phone (480) 279-4400

4915 E Baseline Rd
Ste 115
Gilbert, AZ 85234
Phone (480) 279-4400

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1972591105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1378 E BOSTON ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852966141",
            "telephone_number": "480-570-5318",
            "fax_number": "480-726-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1496 N HIGLEY RD",
            "address_2": "SUITE 104",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852341601",
            "telephone_number": "480-279-4400",
            "fax_number": "480-981-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079582",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.