Individual provider Active NPI

Andrew Glen Noble, O.D.

  • Optometrist
  • Poulsbo, WA
National Provider Identifier
1083963482
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD60299410 Issued in WA
Practice address
20669 Bond Rd NE
Ste 100
Poulsbo, WA 98370-6525
Phone
(360) 626-5220
Fax
(360) 779-3093
NPI assigned
Aug 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD60299410 WA Primary

Addresses

Primary practice location

20669 Bond Rd NE
Ste 100
Poulsbo, WA 98370-6525

Mailing address

20669 Bond Rd NE
Ste 100
Poulsbo, WA 98370-6525
Phone (360) 626-5220

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121105000314 WA Practitioner - Optometry 6608027479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Eyecare of Poulsbo PSGroup PAC ID 6709773807, 5 clinicians

Practice addresses (Care Compare)

2029 E Sims Way
Port Townsend, WA 98368-6905
Phone (360) 385-5386

20669 Bond Rd NE
Poulsbo, WA 98370-6525
Phone (360) 779-2020

Merit-based Incentive Payment System (MIPS)

Final score
91.49 of 100Reported as group
Quality
96.94
Promoting interoperability
100
Improvement activities
40
Cost
74.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Eye Care of Poulsbo PS Optometrist CurrentSince Oct 15, 2012 Accepting new patients
Pacific Eyecare of Poulsbo PS CurrentSince Oct 15, 2012 Accepting new patients

Locations

2029 E Sims Way
Port Townsend, WA 98368
Phone (360) 385-5386

20669 Bond Rd NE
Ste 100
Poulsbo, WA 98370
Phone (360) 779-2020

Interoperability endpoints

  • Direct secure messaging: anoble@pacificeyecare.intellechartdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1083963482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20669 BOND RD NE",
            "address_2": "STE 100",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706525",
            "telephone_number": "360-626-5220",
            "fax_number": "360-779-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20669 BOND RD NE",
            "address_2": "STE 100",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706525",
            "telephone_number": "360-626-5220",
            "fax_number": "360-779-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "ANDREW",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-31",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60299410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

Verify at the official NPI Registry.