NPIMap

Organization Active NPI

Craddock Optometry, PS

Doing business as Eyes on the City

  • Optometrist
  • Seattle, WA
National Provider Identifier
1255634481
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3081 Issued in WA
Legal business name
CRADDOCK OPTOMETRY, PS
Doing business as
Eyes on the City
Practice address
6239 Woodlawn Ave N
Seattle, WA 98103-5716
Phone
(206) 588-2814
Fax
(206) 432-9751
NPI assigned
Dec 9, 2010
Last updated
Jul 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Authorized official

Name
Dr. Leslie Ellen Craddock, O.D.NPI 1922185123
Title
President
Phone
(206) 588-2814

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
Optometrist 152W00000X 3081 WA Primary

Addresses

Primary practice location

6239 Woodlawn Ave N
Seattle, WA 98103-5716

Mailing address

6239 Woodlawn Ave N
Seattle, WA 98103-5716
Phone (206) 588-2814

Other names 1

  • Eyes on the City Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110204000949 WA Part B Supplier - Clinic/Group Practice 6608056833 Receives reassigned benefits from 5 practitioners
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Locations

603 NW 65th St
Seattle, WA 98117
Phone (206) 588-2814

6239 Woodlawn Ave N
Seattle, WA 98103
Phone (206) 588-2814

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1255634481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6239 WOODLAWN AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981035716",
            "telephone_number": "206-588-2814",
            "fax_number": "206-432-9751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6239 WOODLAWN AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981035716",
            "telephone_number": "206-588-2814",
            "fax_number": "206-432-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRADDOCK OPTOMETRY, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-09",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "CRADDOCK",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-588-2814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyes on the City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eyes on the City",
            "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 Jul 21, 2021; 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.