Active NPI
Janice F Hurtubise, O.D.
- Optometrist
- Vancouver, WA
National Provider Identifier
1275617540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3555
- Practice address
- 9317 NE Highway 99
Suite D
Vancouver, WA 98665-8900 - Phone
- (360) 571-3430
- Fax
- (360) 571-3492
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3555 | WA | Primary |
| Optometrist | 152W00000X | 2771ATI | OR |
Addresses
Primary practice location
9317 NE Highway 99
Suite D
Vancouver, WA 98665-8900
Mailing address
14815 NE 5TH CT
Vancouver, WA 98685-5769
Phone (360) 571-2473
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2030633 | Medicaid | WA |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2771ATI | OR | MD | Optometrist |
| 3555 | WA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Janice F Hurtubise, OD, PC | Optometrist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Optometrist
- Vancouver, WA
- NPI 1093780504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275617540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14815 NE 5TH CT",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986855769",
"telephone_number": "360-571-2473",
"fax_number": "360-571-2473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9317 NE HIGHWAY 99",
"address_2": "SUITE D",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986658900",
"telephone_number": "360-571-3430",
"fax_number": "360-571-3492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HURTUBISE",
"first_name": "JANICE",
"middle_name": "F",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "3555",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "2771ATI",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2030633",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.