Individual provider Active NPI

Zachary Giles Nelson, OD

  • Optometrist
  • Bremerton, WA
National Provider Identifier
1164084315
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61310557 Issued in WA
Practice address
2816 Wheaton Way
Bremerton, WA 98310-3433
Phone
(360) 479-2020
NPI assigned
Jul 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT-002354 AZ
Optometrist 152W00000X OD61310557 WA Primary

Addresses

Primary practice location

2816 Wheaton Way
Bremerton, WA 98310-3433

Mailing address

2816 Wheaton Way
Bremerton, WA 98310-3433
Phone (360) 479-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221209002180 WA Practitioner - Optometry 8628303518 Reassigns benefits to 1 organization
Practice locations: Poulsbo, WA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MC Kinney Whitemarsh PLLCGroup PAC ID 6204064389, 3 clinicians

Practice addresses (Care Compare)

2816 Wheaton Way
Bremerton, WA 98310-3433
Phone (360) 479-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT-002354AZMDOptometrist
OD61310557WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
MC Kinney Whitemarsh PLLC Optometrist CurrentSince Oct 18, 2022 Accepting new patients
MC Kinney Whitemarsh PLLC Optometrist CurrentSince Oct 18, 2022 Accepting new patients

Locations

23160 NE State Route 3
Belfair, WA 98528
Phone (360) 275-2020

2816 Wheaton Way
Bremerton, WA 98310
Phone (360) 479-2020

Organizations & group practices 2

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": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1164084315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2816 WHEATON WAY",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103433",
            "telephone_number": "360-479-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 WHEATON WAY",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103433",
            "telephone_number": "360-479-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ZACHARY",
        "middle_name": "GILES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-08",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002354",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61310557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.