Nicholas Leo Koshuta, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1264 Issued in AZ

Practice address

2820 N Glassford Hill Rd
Ste 101
Prescott Valley, AZ 86314-2256

Phone

(928) 775-5606

Fax

(928) 772-4999

NPI assigned

Jun 21, 2005

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

Pennsylvania College of Optometry, 2001

Medicare assignment

May accept Medicare assignment

Group practices

Flagstaff Eye Care PLLCGroup PAC ID 1850315623, 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.

• Flagstaff Eye Care PLLC

  • Optometrist
  • Flagstaff, AZ
  • NPI 1780711317
  Medicare reassignment Care Compare group Authorized official
• DHHS IHS Phoenix Area

  • Clinic/Center
  • Cibecue, AZ
  • NPI 1427335181
  NPD (past)

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1992701494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 N GLASSFORD HILL RD",
            "address_2": "STE 101",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142256",
            "telephone_number": "928-775-5606",
            "fax_number": "928-772-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 N GLASSFORD HILL RD",
            "address_2": "STE 101",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142256",
            "telephone_number": "928-775-5606",
            "fax_number": "928-772-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHUTA",
        "first_name": "NICHOLAS",
        "middle_name": "LEO",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kokopelli Eye Care Surgery Center
• Taja Kolack, RN
• Jeffrey Ryan Kolb, PHARMD
• Kelly Kolp, RD
• Christopher James Kooken, BSN, RN
• Vicki Jayme Kral, BHP
• Susan Marced Kuhner, MA CCC SLP
• Edward John Kuhnley, M.D.
• Anil Kumar, MD
• Alice Kurtz

• Optometrist in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.