John Mortensen, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2118 Issued in AZ

Practice address

204 W Mariposa Rd
Suite 24
Nogales, AZ 85621-1007

Phone

(520) 287-3233

Fax

(520) 281-4583

NPI assigned

Jul 7, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations (25 of 56)

Interoperability endpoints

• Direct secure messaging: dr.john.mortensen@direct.eyecare-partners.com
• FHIR API: https://app.meldrx.com/api/fhir/ecp_cecaz

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.

• Nationwide Optometry P.C.

  • Optometrist
  • Tempe, AZ
  • NPI 1326472945
  Medicare reassignment NPD
• Nationwide Optometry P.C.

  • Optometrist
  • Sun City West, AZ
  • NPI 1427374347
  NPD
• Nationwide Optometry P.C.

  • Optometrist
  • Gilbert, AZ
  • NPI 1023691250
  NPD (past)
• Nationwide Optometry P.C.

  • Optometrist
  • Phoenix, AZ
  • NPI 1073683348
  NPD (past)
• Nationwide Optometry P.C.

  • Optometrist
  • Mesa, AZ
  • NPI 1447973599
  NPD (past)

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

{
    "created_epoch": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1982056552",
    "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",
            "fax_number": "480-893-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W MARIPOSA RD",
            "address_2": "SUITE 24",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211007",
            "telephone_number": "520-287-3233",
            "fax_number": "520-281-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "JOHN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-07",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guadalupe Robles Misquez, N.P.
• Laura C Monarque, NP
• Charise Mae Monge, M.ED, LAC, LMHCA
• Christina F Montez, NURSE
• John A. Moore, CRNA
• Patrick Hugh Mullett, MD
• Kristin Mungarro, DNP, AGNP
• Nourhan Mustafa, M.D.
• L. Hunter Nash, DDS
• Nationwide Optometry P.C.

• Optometrist in Nogales, AZ
• Providers in Nogales, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.