Aeg Washington Professional PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

AEG WASHINGTON PROFESSIONAL PC

Practice address

12310 NE 8TH St Ste 101
Bellevue, WA 98005-3185

Phone

(425) 455-0001

Fax

(314) 741-4947

NPI assigned

Jan 24, 2023

Last updated

Sep 18, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Grant Lindberg, ODNPI 1033149919

Title

Owner

Phone

(618) 462-9818

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Tax ID family

Aeg Washington Professional PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Aeg Washington Professional PC

  dba Rouse EyeCare Center

  • Optometrist
  • Lacey, WA
  • NPI 1285439513
  NPD tax ID
• Aeg Washington Professional PC

  dba Hawks Prairie Vision Clinic

  • Optometrist
  • Lacey, WA
  • NPI 1558166884
  NPD tax ID

Locations

Practitioners 111

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Grant Edward Lindberg, OD

  • Optometrist
  • Bellevue, WA
  • NPI 1033149919
  Medicare reassignment Care Compare group NPD Authorized official
• Meagan-Rhose Abanto, OD

  • Optometrist
  • Everett, WA
  • NPI 1457027880
  Medicare reassignment Care Compare group NPD
• Christina Julia Abercrombie, OD

  • Optometrist
  • Kent, WA
  • NPI 1346906252
  Medicare reassignment Care Compare group NPD
• Margaret Akesson, OD

  • Optometrist
  • Chehalis, WA
  • NPI 1720816945
  Medicare reassignment Care Compare group NPD
• Maryam Ali, OD

  • Optometrist
  • Chehalis, WA
  • NPI 1881371102
  Medicare reassignment Care Compare group NPD
• Hanna Badger

  • Optometrist
  • Longview, WA
  • NPI 1790577880
  Medicare reassignment Care Compare group NPD
• Roderick Blair Beazer, O.D.

  • Optometrist
  • Lake Stevens, WA
  • NPI 1790040673
  Medicare reassignment Care Compare group NPD
• Bryce Bowles, OD

  • Optometrist
  • Lacey, WA
  • NPI 1982497715
  Medicare reassignment Care Compare group NPD
• Brenda Lynn Burden, O.D.

  • Optometrist
  • Kirkland, WA
  • NPI 1760526628
  Medicare reassignment Care Compare group NPD
• Michelle Chan, OD

  • Optometrist
  • Kent, WA
  • NPI 1285113324
  Medicare reassignment Care Compare group NPD
• John N Cheslock, OD

  • Optometrist
  • Longview, WA
  • NPI 1790873370
  Medicare reassignment Care Compare group NPD
• William V Cheslock, OD

  • Optometrist
  • Longview, WA
  • NPI 1649368200
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1134835176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "618-462-9818",
            "fax_number": "314-741-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12310 NE 8TH ST STE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053185",
            "telephone_number": "425-455-0001",
            "fax_number": "314-741-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEG WASHINGTON PROFESSIONAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "LINDBERG",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-462-9818",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.