Active NPI
W Richard Krattli, OD
- Optometrist
- Des Moines, WA
National Provider Identifier
1326136987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD00001598
- Practice address
- 21634 Marine View Drive South
Des Moines, WA 98198-6154 - Phone
- (206) 878-4233
- Fax
- (206) 878-5818
- NPI assigned
- Oct 10, 2006
- Last updated
- Oct 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD00001598 | WA | Primary |
Addresses
Primary practice location
21634 Marine View Drive South
Des Moines, WA 98198-6154
Mailing address
21634 Marine View Drive South
Des Moines, WA 98198-6154
Phone (206) 878-4233
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2009017 | Medicaid | WA | |
| KR2035 | Other | WA | REGENCE BLUE SHIELD |
| 31682 | Other | WA | LABOR & INDUSTRIES |
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 |
|---|---|---|---|
| OD00001598 | WA | MD | Optometrist |
Organizations & group practices 1
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.
-
- Optometrist
- Des Moines, WA
- NPI 1801076989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192492800000",
"number": "1326136987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21634 MARINE VIEW DRIVE SOUTH",
"city": "DES MOINES",
"state": "WA",
"postal_code": "981986154",
"telephone_number": "206-878-4233",
"fax_number": "206-878-5818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21634 MARINE VIEW DRIVE SOUTH",
"city": "DES MOINES",
"state": "WA",
"postal_code": "981986154",
"telephone_number": "206-878-4233",
"fax_number": "206-878-5818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRATTLI",
"first_name": "W",
"middle_name": "RICHARD",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2007-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD00001598",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2009017",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "KR2035",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "31682",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.