Individual provider Active NPI

Nery C. Sison, O.D.

  • Optometrist
  • Bellevue, WA
National Provider Identifier
1093750325
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1678 Issued in WA
Practice address
14700 NE 8TH St
Ste 105
Bellevue, WA 98007-4115
Phone
(425) 746-2122
Fax
(425) 746-1588
NPI assigned
Jun 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1678 WA Primary

Addresses

Primary practice location

14700 NE 8TH St
Ste 105
Bellevue, WA 98007-4115

Mailing address

14700 NE 8TH St
Ste 105
Bellevue, WA 98007-4115
Phone (425) 746-2122

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
I20071115000091 WA Practitioner - Optometry 8820186406 Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093750325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14700 NE 8TH ST",
            "address_2": "STE 105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980074115",
            "telephone_number": "425-746-2122",
            "fax_number": "425-746-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 NE 8TH ST",
            "address_2": "STE 105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980074115",
            "telephone_number": "425-746-2122",
            "fax_number": "425-746-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISON",
        "first_name": "NERY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.