Active NPI
Dixita S Patel, OD
- Optometrist
- Seattle, WA
National Provider Identifier
1053670737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD.60291501
- Practice address
- 1000 Minor Ave Apt 1106
Seattle, WA 98104-1392 - Phone
- (765) 412-0336
- NPI assigned
- May 15, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Optometrist | 152W00000X | OD.60291501 | WA | Primary |
Addresses
Primary practice location
1000 Minor Ave Apt 1106
Seattle, WA 98104-1392
Mailing address
14050 Juanita Dr NE Ste a
Kirkland, WA 98034-9708
Other names 1
- Dixitaben Patel
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 |
|---|---|---|---|
| OD.60291501 | WA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayemura, Inc. | Optometrist | Current | Accepting new patients |
| Mayemura, Inc. | Optometrist | Current | Accepting new patients |
| Darran Kim O.D. PLLC | Optometrist | Current | Accepting new patients |
Locations
10101 19th Ave SE
#B
Everett, WA 98208
Phone (425) 338-5400
14050 Juanita Dr NE
Ste A
Kirkland, WA 98034
Phone (425) 242-8974
23009 56th Ave W
#A
Mountlake Terrace, WA 98043
Phone (253) 517-3334
Organizations & group practices 3
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
- Everett, WA
- NPI 1689857690
-
- Optometrist
- Everett, WA
- NPI 1033891304
-
- Optometrist
- Mountlake Terrace, WA
- NPI 1093098402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1053670737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14050 JUANITA DR NE STE A",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980349708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MINOR AVE APT 1106",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981041392",
"telephone_number": "765-412-0336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "DIXITA",
"middle_name": "S",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-15",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD.60291501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DIXITABEN",
"last_name": "PATEL",
"credential": "OD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.