Individual provider Active NPI

Rikk Jeremy Schlaffman, O.D.

  • Optometrist
  • Puyallup, WA
National Provider Identifier
1144327289
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
BL0500877 Issued in WA
Practice address
1703 S Meridian Ste 101
Puyallup, WA 98371-7590
Phone
(253) 848-3000
Fax
(253) 840-6514
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 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 BL0500877 WA Primary

Addresses

Primary practice location

1703 S Meridian Ste 101
Puyallup, WA 98371-7590

Mailing address

1703 S Meridian Ste 101
Puyallup, WA 98371-7590
Phone (253) 848-3000

Other identifiers 3

IdentifierTypeStateIssuer
2105807MedicaidWA
0337210001OtherWADMERC PROVIDER NUMBER
SC7561OtherWAREGENCE PROVIDER NUMBER

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

LicenseStateTypeSpecialty
BL0500877WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pace Dermatology Associates, PLLC PastSince Oct 15, 2013 Accepting new patients

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1144327289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-848-3000",
            "fax_number": "253-840-6514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-848-3000",
            "fax_number": "253-840-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLAFFMAN",
        "first_name": "RIKK",
        "middle_name": "JEREMY",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "BL0500877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105807",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC PROVIDER NUMBER",
            "identifier": "0337210001",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PROVIDER NUMBER",
            "identifier": "SC7561",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.