Active NPI
Eye MDS of Puget Sound PLLC
- Ophthalmology Physician
- Tacoma, WA
National Provider Identifier
1003858358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- EYE MDS OF PUGET SOUND PLLC
- Practice address
- 4707 S 19TH St
Suite 210
Tacoma, WA 98405-1151 - Phone
- (253) 272-4600
- Fax
- (253) 272-6289
- NPI assigned
- Jun 12, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Melinda Blackwell
- Title
- Administrator
- Phone
- (253) 442-2234
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | Primary |
Addresses
Primary practice location
4707 S 19TH St
Suite 210
Tacoma, WA 98405-1151
Mailing address
4707 S 19TH St
Suite 210
Tacoma, WA 98405-1151
Phone (253) 272-4600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
4707 S 19th St
Ste 210
Tacoma, WA 98405
Phone (253) 248-2020
Practitioners & affiliated clinicians
Practitioners 8
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Ophthalmology Physician
- Olympia, WA
- NPI 1316404999
-
- Ophthalmology Physician
- Renton, WA
- NPI 1235289513
-
- Ophthalmology Physician
- Tacoma, WA
- NPI 1679096010
-
- Ophthalmology Physician
- Seattle, WA
- NPI 1093006694
-
- Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
- Tacoma, WA
- NPI 1922508530
Ophthalmology
-
- Ophthalmology Physician
- Tacoma, WA
- NPI 1386683837
-
- Ophthalmology Physician
- Olympia, WA
- NPI 1598717860
-
- Ophthalmology Physician
- Tacoma, WA
- NPI 1770528721
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1707868800000",
"number": "1003858358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4707 S 19TH ST",
"address_2": "SUITE 210",
"city": "TACOMA",
"state": "WA",
"postal_code": "984051151",
"telephone_number": "253-272-4600",
"fax_number": "253-272-6289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4707 S 19TH ST",
"address_2": "SUITE 210",
"city": "TACOMA",
"state": "WA",
"postal_code": "984051151",
"telephone_number": "253-272-4600",
"fax_number": "253-272-6289"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EYE MDS OF PUGET SOUND PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-12",
"last_updated": "2024-02-14",
"certification_date": "2024-02-14",
"status": "A",
"authorized_official_last_name": "BLACKWELL",
"authorized_official_first_name": "MELINDA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "253-442-2234"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.