NPIMap

Organization Active NPI

Lighthouse for the Blind, Inc

  • Low Vision Rehabilitation Optometrist
  • Seattle, WA
National Provider Identifier
1205478559
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X
Legal business name
LIGHTHOUSE FOR THE BLIND, INC
Doing business as
Lighthouse Low Vision Clinic
Practice address
2501 S Plum St
Seattle, WA 98144-4711
Phone
(206) 322-4200
NPI assigned
Oct 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Authorized official

Name
Anna ShagasNPI 1780971440
Title
Optometrist
Phone
(206) 229-0906

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
Low Vision Rehabilitation OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WL0500X Primary

Addresses

Primary practice location

2501 S Plum St
Seattle, WA 98144-4711

Mailing address

2501 S Plum St
Seattle, WA 98144-4711

Other names 1

  • Lighthouse Low Vision Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200428000934 WA Part B Supplier - Clinic/Group Practice 4587094800 Receives reassigned benefits from 4 practitioners
Practice locations: Seattle, WA; Sedro Woolley, WA

National Provider Directory

National Provider Directory

Locations

2501 S Plum St
Seattle, WA 98144
Phone (206) 322-4200

2131 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 416-6735

Practitioners & affiliated clinicians

Practitioners 4

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": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1205478559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 S PLUM ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981444711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 S PLUM ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981444711",
            "telephone_number": "206-322-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE FOR THE BLIND, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-08",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "SHAGAS",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "206-229-0906"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Low Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lighthouse Low Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 27, 2020; 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.