JUSTIN CROCKETT
NPI 1417583915
Optometrist in Glendale, AZ

Q: What is Justin Crockett's NPI number?

The NPI number for Justin Crockett is 1417583915. It was assigned to this individual provider in the NPPES registry on March 16, 2020.

Q: What is Justin Crockett's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Justin Crockett was last updated on December 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since March 16, 2020PECOS Enrolled

5891 W EUGIE AVE, GLENDALE, AZ 85304(800) 233-3264 Get Directions Write a Review

NPPES record last updated: December 7, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 7, 2021, Jul 7, 2020, Mar 16, 2020 (3 updates tracked since 2020).

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About Justin Crockett NPPES

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

JUSTIN CROCKETT (NPI 1417583915) is an individual optometrist in Glendale, Arizona, licensed in Arizona (OPT-002445) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1417583915

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameJUSTIN CROCKETT

Location Address5891 W EUGIE AVEGlendale, AZ 85304-1252

Mailing Address25500 N Norterra DrPhoenix, AZ 85085-8200 · (623) 277-2370

Phone(800) 233-3264

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateMarch 16, 2020

Last NPPES UpdateDecember 7, 20213 updates tracked since enumeration

NPPES CertifiedDecember 7, 2021

✔ NPI 1417583915 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 · OPT-002445

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.

5891 W EUGIE AVE, Glendale, AZ 85304

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin Crockett is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8022436146

PECOS Enrollment IDI20200922000177

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

20 services20 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85304 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$127.71 typical visit price

range $55.44 – $168.60

Typical copayment $31.92 (range $13.86 – $42.15)

Most-billed visit code 99204

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EARL EUGENE ROTH JR. MD

Pediatrics