Ian Matthew Cheslock

Primary specialty

OptometristTaxonomy code 152W00000X

License

61169322 Issued in WA

Practice address

950 11TH Ave
Longview, WA 98632-2504

Phone

(360) 577-1500

Fax

(360) 425-0735

NPI assigned

Aug 5, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

Pacific University - College of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Warm Springs Health and Wellness DHHS IHS Warm Springs Service UnitGroup PAC ID 2668490970, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Warm Springs Health and Wellness DHHS IHS Warm Springs Service Unit

  • Clinic/Center
  • Warm Springs, OR
  • NPI 1417084708

  TX

  Medicare reassignment Care Compare group NPD
• Cascade Eye Care PS

  • Optometrist
  • Longview, WA
  • NPI 1396815585
  Medicare reassignment NPD
• Mescalero Indian Hospital

  • Rural Acute Care Hospital
  • Mescalero, NM
  • NPI 1891886065

  TX

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1003580762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322504",
            "telephone_number": "360-577-1500",
            "fax_number": "360-425-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322504",
            "telephone_number": "360-577-1500",
            "fax_number": "360-425-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESLOCK",
        "first_name": "IAN",
        "middle_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "61169322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Cheng, M.D.
• Adam Thomas Cherry, PA-C
• Dru Cherry
• Chad C Chesley, M.D.
• Susan Lynn Chesley, CRNA
• John N Cheslock, OD
• William V Cheslock, OD
• Child & Adolescent Clinic, PS
• Child and Adolescent Clinic
• Alyssa Nicole Childers

• Optometrist in Longview, WA
• Providers in Longview, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.