Lawrence William Nivala, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD2046 Issued in WA

Practice address

114 E 1St St
Port Angeles, WA 98362-2903

Phone

(360) 452-2361

Fax

(360) 452-2362

NPI assigned

Jan 24, 2006

Sex

Male

Sole proprietor

Yes

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

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

Specialty

Optometry

Education

Southern California College of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eric a. Van Orman, IncGroup PAC ID 9739360363, 2 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 and National Provider Directory roles.

• Eric a. Van Orman, Inc

  • Optometrist
  • Port Angeles, WA
  • NPI 1447568415
  Medicare reassignment Care Compare group NPD
• Angeles Vision Clinic, Inc.

  • Optometrist
  • Port Angeles, WA
  • NPI 1265607071
  NPD (past)

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1235109174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E 1ST ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983622903",
            "telephone_number": "360-452-2361",
            "fax_number": "360-452-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E 1ST ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983622903",
            "telephone_number": "360-452-2361",
            "fax_number": "360-452-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIVALA",
        "first_name": "LAWRENCE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD2046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2025120",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly D Newhouse
• Cynthia Susan Newman, RDH
• Deidre Andrias Newton, MSW
• Travis Nicolaysen
• Matthew Nienow
• Brianna Brenda Leah Noach, M.AC., LMP, MSW
• Jennifer Nolan
• Jeff Paul Norberg, LMP
• Terry Ann Norberg, LMP
• Dawn Yvette Norbisrath

• Optometrist in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; 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.