SPECTRA EYE INSTITUTE LLC NPI 1962943118

NPI Information

NPI: 1962943118
Provider Name: SPECTRA EYE INSTITUTE, LLC
Classification: Clinic/Center - 261QS0132X
Entity Type: Organization

Specialization: Ophthalmologic Surgery

CLIA Number: 03D2127272

Address:
15401 N 29TH AVE
201
PHOENIX, AZ
ZIP 85053
Phone: (623) 583-2020
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SPECTRA EYE INSTITUTE, LLC is an ophthalmologic surgery clinic center in Phoenix, AZ. SPECTRA EYE INSTITUTE, LLC NPI is 1962943118. The provider is registered as an organization entity type.

The provider's business location address is:

15401 N 29TH AVE
201
PHOENIX, AZ
ZIP 85053-001
Phone: (623) 583-2020
Fax: (623) 583-2513

The provider's authorized official is Jan Amator .
The authorized official title is Ceo and has the following contact phone number (623) 583-2020.

The CLIA number assigned to this NPI record is 03D2127272 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/20/2017 and was last updated on 11/15/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			No
2	261QS0132X	Clinic/Center	Ophthalmologic Surgery			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	544256	OTHER	ARIZONA	AHCCCS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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