Organization Active NPI

Sightconnection

  • Low Vision Rehabilitation Optometrist
  • Seattle, WA
National Provider Identifier
1154337996
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X
License
OD00003043 Issued in WA
Legal business name
SIGHTCONNECTION
Practice address
9709 Third Ave NE
Suite 100
Seattle, WA 98115
Phone
(206) 525-5556
Fax
(206) 525-0422
NPI assigned
Aug 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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

Authorized official

Name
Miles Otoupal
Title
Board Chairman
Phone
(206) 525-5556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WL0500X OD00003043 WA Primary

Addresses

Primary practice location

9709 Third Ave NE
Suite 100
Seattle, WA 98115

Mailing address

9709 Third Ave NE
Suite 100
Seattle, WA 98115
Phone (206) 525-5556

Other identifiers 1

IdentifierTypeStateIssuer
2023190MedicaidWA

Other names 1

  • Community Services for the Blind and Partially Sighted Former legal business name

National Provider Directory

National Provider Directory

Locations

9709 3rd Ave NE
Ste 100
Seattle, WA 98115
Phone (206) 525-5556

929 N 130th St
Ste 3
Seattle, WA 98133
Phone (206) 525-5556

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414454400000",
    "number": "1154337996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 THIRD AVE NE",
            "address_2": "SUITE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98115",
            "telephone_number": "206-525-5556",
            "fax_number": "206-525-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9709 THIRD AVE NE",
            "address_2": "SUITE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98115",
            "telephone_number": "206-525-5556",
            "fax_number": "206-525-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGHTCONNECTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2014-10-28",
        "status": "A",
        "authorized_official_last_name": "OTOUPAL",
        "authorized_official_first_name": "MILES",
        "authorized_official_title_or_position": "BOARD CHAIRMAN",
        "authorized_official_telephone_number": "206-525-5556"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "WA",
            "license": "OD00003043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2023190",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Services for the Blind and Partially Sighted",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.