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NPI 1245821859ActiveIndividual· Optometrist· Tucson, AZ

Optometrist in Tucson, Arizona, trained at Southern California College of Optometry (class of 2021). Enrolled in Medicare as practitioner - optometry. Biotissue Holdings Inc. reported $13.28 in payments in 2024, mostly food and beverage.

Overview

NPI1245821859
StatusActive
Entity typeIndividual
Sole proprietorNo
NPI issuedJan 27, 2021
Last updated in NPPESAug 24, 2023
Certified by providerAug 24, 2023

Specialties and licenses

TaxonomyCodeLicenseState
Optometrist Primary152W00000X002488AZ

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Optometry (AZ)

Medicare sources and data years

Education and affiliations

Medical schoolSouthern California College of Optometry
Graduation year2021
Medicare specialtyOptometry

Source: CMS Care Compare

Industry payments (Open Payments)

  • 2024$13.28 · 1 payment from 1 company

Top paying companies in 2024

CompanyAmountPayments
Biotissue Holdings Inc.$13.281

What the 2024 payments were for

  • Food and Beverage$13.28 · 1 payment

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

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