Active NPI
William Joseph Prothero, O.D.
- Optometrist
- Bellevue, WA
National Provider Identifier
1144223405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD00001765
- Practice address
- 1837 156TH Ave NE
Ste 201
Bellevue, WA 98007-4387 - Phone
- (425) 643-2020
- Fax
- (425) 643-0859
- NPI assigned
- May 31, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD00001765 | WA | Primary |
| Optometrist | 152W00000X | 9074 | CA |
Addresses
Primary practice location
1837 156TH Ave NE
Ste 201
Bellevue, WA 98007-4387
Mailing address
1837 156TH Ave NE
Ste 201
Bellevue, WA 98007-4387
Phone (425) 643-2020
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0103457 | Other | WA | WA WORKERS COMP ID |
| 2016038 | Medicaid | WA | |
| 8469PR | Other | WA | REGENCE WA BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9074 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1144223405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1837 156TH AVE NE",
"address_2": "STE 201",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980074387",
"telephone_number": "425-643-2020",
"fax_number": "425-643-0859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1837 156TH AVE NE",
"address_2": "STE 201",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980074387",
"telephone_number": "425-643-2020",
"fax_number": "425-643-0859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROTHERO",
"first_name": "WILLIAM",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-31",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD00001765",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "9074",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA WORKERS COMP ID",
"identifier": "0103457",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2016038",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE WA BS",
"identifier": "8469PR",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.