Glen R Owen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1736TX Issued in WA

Practice address

7315 212TH St SW
Ste 200
Edmonds, WA 98026-7610

Phone

(425) 774-2020

Fax

(425) 670-8932

NPI assigned

Oct 13, 2006

Last updated

Feb 28, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA, OK, TX3 enrollments

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 3

Specialty

Optometry

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Washington Professional PCGroup PAC ID 3476927997, 61 clinicians

Edmonds Eyecare Associates Inc PSGroup PAC ID 6103715370, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Edmonds Eyecare Associates Inc PS

  • Optometrist
  • Edmonds, WA
  • NPI 1558451369
  Medicare reassignment Care Compare group NPD Authorized official
• Aeg Washington Professional PC

  • Optometrist
  • Bellevue, WA
  • NPI 1134835176
  Medicare reassignment Care Compare group NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment NPD
• Northeastern State University College of Optometry

  • Optometrist
  • Tahlequah, OK
  • NPI 1437106333
  Medicare reassignment NPD
• Cherokee Nation

  dba Cherokee Nation Public Health

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1275799645
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Salina, OK
  • NPI 1326054081
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Vinita, OK
  • NPI 1558377226
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1174613715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7315 212TH ST SW",
            "address_2": "STE 200",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267610",
            "telephone_number": "425-774-2020",
            "fax_number": "425-670-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7315 212TH ST SW",
            "address_2": "STE 200",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267610",
            "telephone_number": "425-774-2020",
            "fax_number": "425-670-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "GLEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1736TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2013944",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meaghan Ormsby, RD
• Erin M Orourke, DPM
• Thomas Osterdahl, CDP
• Kristin Ott, MSW, LSWAIC
• Sarah Elizabeth Ouano, ND
• Tracy Ozanich, LMP
• Pacific Healthcare, LLC
• Pacific Mental Health
• Pacific Nutrition & Wellness
• Pacific Vascular Incorporated (Pacific Vascular-Edmonds)

• Optometrist in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.