MEDICARE: ANTHEM EYE CARE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WP0200X	Pediatric Optometrist
2	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	211518	OTHER	EYEMED
3	25628	OTHER	AVESIS
4	AE26751	OTHER	SPECTERA

General Provider Information

NPI Number	:	1639329386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTHEM EYE CARE PC

Provider Business Mailing Address
First Line	:	4205 W ANTHEM WAY STE 101
Second Line	:
City	:	ANTHEM
State	:	AZ
Zip	:	85086-0445
Country	:	US
Telephone Number	:	623-879-3937
Fax Number	:	623-551-2051

Provider Business Practice Location Address
First Line	:	4205 W ANTHEM WAY STE 101
Second Line	:
City	:	ANTHEM
State	:	AZ
Zip	:	85086-0445
Country	:	US
Telephone Number	:	623-879-3937
Fax Number	:	623-551-2051

Authorized Official
Title or Position	:	OWNER
Name	:	LAWRENCE RICHARD STERN
Credential	:	OD
Telephone Number	:	623-879-3937

Provider Enumeration Date	:	09/30/2008
Last Update Date	:	03/18/2026

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Directions to “ANTHEM EYE CARE PC ” Practice Location

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