Individual provider Active NPI

Jacob Gilbar

  • Optometrist
  • Bellevue, WA
National Provider Identifier
1124473764
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD60658517 Issued in WA
Practice address
10670 NE 29TH St
Apt 87
Bellevue, WA 98004-2010
Phone
(425) 214-2021
NPI assigned
May 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD60658517 WA Primary

Addresses

Primary practice location

10670 NE 29TH St
Apt 87
Bellevue, WA 98004-2010

Mailing address

10670 NE 29TH St
Apt 87
Bellevue, WA 98004-2010

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
I20170403000891 WA Practitioner - Optometry 4385929454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alderwood Optometric Services PLLCGroup PAC ID 1951686575, 3 clinicians

Practice addresses (Care Compare)

2502 196TH St SW
Suite 114
Lynnwood, WA 98036-7091
Phone (425) 771-2662

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD60658517WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Alderwood Optometric Services PLLC Optometrist CurrentSince Feb 13, 2017 Accepting new patients

Locations

2502 196th St SW
Ste 114
Lynnwood, WA 98036
Phone (425) 771-2662

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.

NPI Registry JSON

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1124473764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10670 NE 29TH ST",
            "address_2": "APT 87",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10670 NE 29TH ST",
            "address_2": "APT 87",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042010",
            "telephone_number": "425-214-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBAR",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-02",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60658517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.