Individual provider Active NPI

James Daniel Abel, OD

  • Optometrist
  • Renton, WA
National Provider Identifier
1255945390
Registry record updated Sep 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61096235 Issued in WA
Practice address
17801 108TH Ave SE
Renton, WA 98055-6423
Phone
(206) 430-4600
NPI assigned
Sep 5, 2020
Last updated
Sep 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD61096235 WA Primary

Addresses

Primary practice location

17801 108TH Ave SE
Renton, WA 98055-6423

Mailing address

15902 98TH Ave NE
Bothell, WA 98011-7512
Phone (206) 430-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20241104002498 CA Practitioner - Optometry 5799190690 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35124CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Tedder Optometry Group, PC Optometrist CurrentSince Oct 1, 2024 Accepting new patients
Tedder Optometric Clinic Management, P.C. Optometrist PastSince Mar 12, 2023 Accepting new patients

Locations

530 New Los Angeles Ave
Ste 115269
Moorpark, CA 93021
Phone (805) 624-1255

939 W Arrow Hwy
San Dimas, CA 91773
Phone (909) 279-2472

Interoperability endpoints

  • Direct secure messaging: james.abel@70976835354628.direct.elationemr.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1599264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599264000000",
    "number": "1255945390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15902 98TH AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980117512",
            "telephone_number": "206-430-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17801 108TH AVE SE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556423",
            "telephone_number": "206-430-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABEL",
        "first_name": "JAMES",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-05",
        "last_updated": "2020-09-05",
        "certification_date": "2020-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61096235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.