Jacob Richard Bromley, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

002462 Issued in AZ

Practice address

725 E Main St, Apt #1C
Somerton, AZ 85350

Phone

(928) 627-4525

NPI assigned

Sep 11, 2020

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

Specialty

Optometry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nicolex LLCGroup PAC ID 3870805179, 2 clinicians

Somerton Eyecare Center IncGroup PAC ID 9133221369, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Somerton Eyecare Center Inc

  • Optometrist
  • Somerton, AZ
  • NPI 1306981386
  Medicare reassignment Care Compare group NPD
• Nicolex LLC

  • Optometrist
  • Phoenix, AZ
  • NPI 1003221185
  Medicare reassignment Care Compare group
• Aleta B. Gong-Tang, OD, PC

  • Optometrist
  • Phoenix, AZ
  • NPI 1235301896
  NPD (past)
• Northwest Valley Eye Care, LLC

  • Optometrist
  • Sun City, AZ
  • NPI 1669662789
  NPD (past)

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1992310312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17439 N 57TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083819",
            "telephone_number": "925-708-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 E MAIN ST, APT #1C",
            "city": "SOMERTON",
            "state": "AZ",
            "postal_code": "85350",
            "telephone_number": "928-627-4525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16020 N 35th Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850533823",
            "country_code": "US",
            "telephone_number": "602-547-3255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14435 N 7th St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850224378",
            "country_code": "US",
            "telephone_number": "602-993-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10336 W Coggins Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Sun City",
            "state": "AZ",
            "postal_code": "853513470",
            "country_code": "US",
            "telephone_number": "623-933-2013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROMLEY",
        "first_name": "JACOB",
        "middle_name": "RICHARD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-11",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "002462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norma Arreola, MASTERS
• Jody Marie Attaway
• Stephen Douglas Bailey, ED. D.
• Miriam G Beltran
• Mark Beverly, PSY.D
• James Burrell
• Alberto Cabrera Jr., FNP-BC
• Campesinos Sin Fronteras
• Angelica Carlos
• Luz Isela Casarez Negrete

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.