Active NPI
Dale D Heaston, OD
- Optometrist
- Richland, WA
National Provider Identifier
1003924374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1129
- Practice address
- 1321 Aaron Dr
Richland, WA 99352-4678 - Phone
- (509) 943-3171
- Fax
- (509) 946-0905
- NPI assigned
- Aug 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1129 | WA | Primary |
Addresses
Primary practice location
1321 Aaron Dr
Richland, WA 99352-4678
Mailing address
1321 Aaron Dr
PO Box 610
Richland, WA 99352-4678
Phone (509) 943-3171
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4100016629 | Other | RAILROAD MEDICARE | |
| HE6761 | Other | BLUE CROSS BLUE SHIELD | |
| 11102 | Other | GROUP HEALTH | |
| 0144211 | Other | WA | WA LABOR & INDUSTRY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1129 | WA | MD | Nutrition Education Nutritionist |
Organizations & group practices 1
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.
-
- Optometrist
- Richland, WA
- NPI 1972629871
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1003924374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1321 AARON DR",
"address_2": "PO BOX 610",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993524678",
"telephone_number": "509-943-3171",
"fax_number": "509-946-0905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1321 AARON DR",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993524678",
"telephone_number": "509-943-3171",
"fax_number": "509-946-0905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEASTON",
"first_name": "DALE",
"middle_name": "D",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-28",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "1129",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "4100016629",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "HE6761",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH",
"identifier": "11102",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA LABOR & INDUSTRY",
"identifier": "0144211",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.