Anup K. Deol, OD PS
Organization Active NPI Optometrist · Snohomish, WA
NPI 1265627244 · NPPES record last updated Jul 24, 2008
Key facts
- NPI
- 1265627244
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 2023 (WA)
- Legal business name
- ANUP K. DEOL, OD PS
- Practice address
- 415 Avenue D
Snohomish, WA 98290-2747 - Phone
- (360) 568-6666
- Fax
- (360) 568-1221
- NPI assigned
- Sep 12, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Anup Deol, OD
- Title
- President
- Phone
- (360) 568-6666
Practitioners 2
-
Anup Deol, OD
-
Casey J Andrus, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040726001197 | WA | Part B Supplier - Clinic/Group Practice | 4688644990 |
Receives reassigned benefits from 1 practitioner Practice locations: Snohomish, WA |
National Provider Directory
Locations
415 Avenue D
Snohomish, WA 98290
Phone (206) 568-6666
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 2023 | WA | Yes |
Addresses
Primary practice location
415 Avenue D
Snohomish, WA 98290-2747
Mailing address
415 Avenue D
Snohomish, WA 98290-2747
Phone (360) 568-6666
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2026128 | Medicaid | WA |
Other names
- Eyecare Center of Snohomish
Other providers in Snohomish, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.