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MALLAVIA OD PC
NPI 1417169251
Optometrist in Page, AZ

Active since May 04, 2007
124 SIXTH AVE, BOX 1806, PAGE, AZ 86040(928) 645-2772(928) 645-9508 Get Directions Write a Review

NPPES record last updated: December 31, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mallavia Od Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MALLAVIA OD PC (NPI 1417169251) is a healthcare organization registered as an optometrist in Page, Arizona and active in the NPI registry since May 2007. The organization lists David F Mallavia, President, as its authorized official.

NPPES Registry Identity

NPI1417169251
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameMALLAVIA OD PC
Location Address124 SIXTH AVE, BOX 1806Page, AZ 86040-1806
Mailing AddressPo Box 1806, 124 6 AvePage, AZ 86040-1806 · (928) 645-2772 · Fax (928) 645-9508
Phone(928) 645-2772
Fax(928) 645-9508
Organization SubpartNo
Authorized OfficialDavid F MallaviaPresident · (928) 645-2772
Enumeration DateMay 4, 2007
Last NPPES UpdateDecember 31, 2007
✔ NPI 1417169251 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in AZ · 1379
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
124 SIXTH AVE, Page, AZ 86040
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Other Identifiers 3

Medicare UPINV01939AZ
Medicare PINZ84938AZ
Medicare NSC5519260001AZ

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 3

Medicare supplier enrollment and the product categories Mallavia Od PC carries, from the Medicare DMEPOS supplier directory.

Mallavia Od PC

DMEPOS supplier · Page, AZ
✔

Accepts Medicare assignment

Mallavia Od PC agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20586725
Medicare Participant SinceOctober 21, 2004
Supplier Location420 N NavajoPage, AZ 86040
Phone(928) 645-2772
Supplier Specialties
Optometrist Optician

Medicare Product Categories

Ocular Prostheses
Prosthetic eyes
Prosthetic Lenses: Conventional Eyeglasses
Conventional Eyeglasses
Prosthetic Lenses: Conventional Contact Lenses
Conventional Contact Lenses
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mallavia Od PC's NPI number?

The NPI number for Mallavia Od PC is 1417169251. It was assigned to this organization in the NPPES registry on May 4, 2007.

Where is Mallavia Od PC located?

Mallavia Od PC is located at 124 Sixth Ave Box 1806, Page, AZ 86040. The listed phone number is (928) 645-2772.

What is Mallavia Od PC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Does Mallavia Od PC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Mallavia Od PC accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Mallavia Od PC accept?

Health plans from Ambetter from Arizona Complete Health list Mallavia Od PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mallavia Od PC was last updated on December 31, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.