Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justin Crockett

Individual provider Optometrist · NPI 1417583915

Justin Crockett is an Optometry in Glendale, Arizona. Qualified in 2020, 6 years ago. Practices with Wind River Family and Community Healthc Care, a 41-clinician group. Licensed in Arizona.

Years since qualifying
6
Licensed in
AZ
In the registry since
2020
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Practice location Address checks out

5891 W Eugie Ave
Glendale, AZ 85304-1252
Phone: (800) 233-3264
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence OPT-002445 (AZ)

Record details

NPI number1417583915
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 16, 2020
Last updated in NPPESDecember 7, 2021
Certification dateDecember 7, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Wind River Family And Community Healthc Care — 41 clinicians
Accepts Medicare assignment Not indicated

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