NPIMap

Organization Active NPI

Division Eyecare

  • Optometrist
  • Oak Harbor, WA
National Provider Identifier
1154536217
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003639 Issued in WA
Legal business name
DIVISION EYECARE
Practice address
31775 State Route 20
Suite B
Oak Harbor, WA 98277-5139
Phone
(360) 544-5843
Fax
(360) 544-5839
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Authorized official

Name
Dr. Mark D Aginsky, ODNPI 1730169285
Title
Owner
Phone
(360) 544-5843

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OD00003639 WA Primary

Addresses

Primary practice location

31775 State Route 20
Suite B
Oak Harbor, WA 98277-5139

Mailing address

31775 State Route 20
Suite B
Oak Harbor, WA 98277-5139
Phone (360) 544-5843

Other identifiers 1

IdentifierTypeStateIssuer
1024566MedicaidWA

Other names 1

  • Vision Plus Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070915000313 WA Part B Supplier - Clinic/Group Practice 1456445840 Receives reassigned benefits from 6 practitioners
Practice locations: Oak Harbor, WA

National Provider Directory

National Provider Directory

Locations

31775 State Route 20
Ste B
Oak Harbor, WA 98277
Phone (360) 544-5843

31775 State Route 20
Ste B1
Oak Harbor, WA 98277
Phone (360) 544-5843

32895 State Route 20
Oak Harbor, WA 98277

Practitioners & affiliated clinicians

Practitioners 10

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": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1154536217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31775 STATE ROUTE 20",
            "address_2": "SUITE B",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775139",
            "telephone_number": "360-544-5843",
            "fax_number": "360-544-5839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31775 STATE ROUTE 20",
            "address_2": "SUITE B",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982775139",
            "telephone_number": "360-544-5843",
            "fax_number": "360-544-5839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVISION EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "AGINSKY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-544-5843",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024566",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Plus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.